Clinical and Laboratory Profile of Zika and Dengue Infected Patients: Lessons Learned From the Co-circulation of Dengue, Zika and Chikungunya in Brazil

Azeredo, Elzinandes Leal de; Santos, Flávia Barreto dos; Barbosa, Luciana Santos; Souza, Thiara Manuele Alves de; Badolato-Corrêa, Jéssica; Sánchez‐Arcila, Juan Camilo; Nunes, Priscila Conrado Guerra; de-Oliveira-Pinto, Luzia Maria; Filippis, Ana Maria de; Fabbro, Márcia Dal; Romanholi, Izilyanne Hoscher; Cunha, Rivaldo Venâncio da

doi:10.1371/currents.outbreaks.0bf6aeb4d30824de63c4d5d745b217f5

Cited by 55 publications

(65 citation statements)

References 39 publications

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“…Our data indicates that muscle is a target for ZIKV replication and site of injury. The ZIKV ability to infect and induce muscle damage is consistent with the high frequency of myalgia in patients, including those cases of self-limited disease and with neurological complications (32-34). In addition, it also suggests that an initial muscular replication may be a common step before ZIKV reaches neural structure.…”

Section: Discussionmentioning

confidence: 53%

Zika virus replicates in skeletal muscle contributing to peripheral viral amplification prior to reach neural tissue

Gavino-Leopoldino

et al. 2020

Preprint

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Zika virus (ZIKV) infections are still a worldwide concern due to the severity of neurological outcomes. ZIKV neurotropism is well characterized, but peripheral tissue could be sites of viral amplification, contributing to endothelial-barrier crossing and access to peripheral nerves. During acute and late phases of infection, ZIKV can be detected in several body fluids, eyes, testis and vagina. However, the importance of initial replication sites for the establishment of infection and viral spread remain unknown. Here we demonstrated that ZIKV replicates primarily in human muscle precursor cells, resulting in cell death and inhibition of myogenesis. ZIKV also replicates in fetal muscle after maternal transmission and in infected neonate mice, inducing lesions and inflammation. Muscle was an important site of viral amplification, sustaining higher peripheral viral loads than liver and spleen. In addition, ZIKV showed rapid and sustained replication kinetics in muscle even before replication in the neural tissues, persisting until 16 days post infection. Our results highlight the importance of muscle in ZIKV pathogenesis as a peripheral site of viral amplification which may contribute to ZIKV reaching neural structures.Author SummaryZika Virus (ZIKV) neurotropism and its deleterious effects on central nervous system have been well characterized. But, investigations of the initial replication sites for the establishment of infection and viral spread to neural tissues remain under explored. Here we demonstrated that ZIKV replicates primarily in human skeletal muscle precursor cells, resulting in cell death and disrupted myogenesis. ZIKV also replicates in muscle of fetus and neonate mice inducing muscle damage and inflammation. Muscle replication occurs before amplification in peripheral nerves and brain, contributing to the increase of peripheral ZIKV load and dissemination. In addition, ZIKV RNA still been detected in skeletal muscle at late stages of infection. Overall, our findings showed that skeletal muscle is involved in ZIKV pathogenesis, contributing to a broader understanding of ZIKV infection. Thus, opens new aspects in the investigation of the long-term consequence of early infection.

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Section: Discussionmentioning

confidence: 53%

Zika virus replicates in skeletal muscle contributing to peripheral viral amplification prior to reach neural tissue

Gavino-Leopoldino

et al. 2020

Preprint

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“…In Brazil, a recent study conducted by19 during a dengue and zika epidemic in the state of Mato Grosso do Sul in 2016, identified patients co‐infected with DENV/ZIKV. Another study by the same group, investigating the triple epidemic (dengue, zika, and chikungunya) occurred in RJ in 2016, also reported distinct arboviral co‐infections: CHIKV/ZIKV, CHIKV/DENV, and DENV/ZIKV (manuscript in preparation).…”

Section: Resultsmentioning

confidence: 99%

First detection and molecular characterization of a DENV‐1/DENV‐4 co‐infection during an epidemic in Rio de Janeiro, Brazil

Bruycker-Nogueira

Faria

Nunes

et al. 2018

Clinical Case Reports

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Key Clinical MessageIn the 80s, dengue viruses type 1 and 4 (DENV‐1 and 4) were isolated in North region of Brazil. However, it was only after the DENV‐1 introduction in the state of Rio de Janeiro (RJ) in mid‐1980s, that dengue became a nationwide public health problem. In 2009, this serotype re‐emerged causing an explosive epidemic in the country. DENV‐4 was first detected in RJ in 2011 and in 2012, and DENV‐1 and 4 were co‐circulating and responsible for a high number of cases notifications. Here, we describe the detection and molecular characterization of a DENV‐1/4 co‐infection in sample of 2012 in RJ.

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“…En línea con lo reportado en otros estudios sobre dengue en pediatría, [11][12][13][14] (más importante en los primeros 5 días de enfermedad), la plaquetopenia y el aumento de transaminasas. Dado que no existe un tratamiento específico, el reconocimiento precoz de los signos de alarma y el control hematológico resulta fundamental para detectar a los niños en riesgo y ofrecerles tratamiento de soporte en forma precoz.…”

Section: Figura 1 Distribución De Casos Autóctonos E Importados Segúunclassified

Brote epidémico de dengue en la Ciudad de Buenos Aires, 2016: características clínicas y hematológicas de la infección en una población pediátrica

et al. 2019

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RESUMENEl dengue es la arbovirosis humana que más morbimortalidad ocasiona mundialmente. Durante 2016, se registró, en la Ciudad de Buenos Aires, Argentina, la mayor epidemia de esta enfermedad. Objetivo: describir las características clínicas y hematológicas en una población pediátrica. Métodos: estudio de corte transversal que incluyó a pacientes atendidos del 18-1-16 al 15-4-16 en el Hospital de Niños "Dr. Ricardo Gutiérrez". Resultados: se registraron 156 casos, 82 confirmados por virología; 130 (83 %), autóctonos. Las manifestaciones clínicas más frecuentes fueron fiebre, cefalea y dolor retroocular. Las alteraciones del laboratorio significativas fueron leucopenia, plaquetopenia y aumento de transaminasas. Se internaron 35 pacientes (23 %), 25 (16 %) con signos de alarma. No se presentó ningún caso de dengue grave. Conclusiones: el reconocimiento oportuno de los signos de alarma y el control hematológico resultan fundamentales para detectar a los niños en riesgo y ofrecerles tratamiento de soporte en forma precoz. Palabras clave: virus del dengue, niño, pediatría. ABSTRACTDengue is the human arbovirus with the highest morbidity and mortality in the world. The largest outbreak of dengue in Buenos Aires, Argentina, occurred during 2016. Dengue outbreak in Buenos Aires, Argentina, 2016: Clinical and hematological features in children Objective: To describe clinical and hematological features in children with confirmed dengue infection. Methods: Cross sectional study that included children attended since January 18 th to April 15 th 2016 at Hospital de Niños "Dr. Ricardo Gutiérrez". Results: among 156 registered cases, 82 confirmed cases by virology test; 130 (83 %) autochthonous cases. The most frequent clinical manifestations were fever, headache and retro-ocular pain. Laboratory abnormalities were leukopenia, thrombocytopenia and increased liver enzymes. Thirty-five children were hospitalized (23 %), 25 (16 %) with warning signs. In our study, no cases of severe dengue occurred. Conclusions: early recognition of warning signs and hematological monitoring is essential in order to detect patients at risk and offer them adequate early treatment. Brote epidémico de dengue en la Ciudad de Buenos Aires, 2016: características clínicas y hematológicas de la infección en una población pediátrica

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Clinical and Laboratory Profile of Zika and Dengue Infected Patients: Lessons Learned From the Co-circulation of Dengue, Zika and Chikungunya in Brazil

Cited by 55 publications

References 39 publications

Zika virus replicates in skeletal muscle contributing to peripheral viral amplification prior to reach neural tissue

Zika virus replicates in skeletal muscle contributing to peripheral viral amplification prior to reach neural tissue

First detection and molecular characterization of a DENV‐1/DENV‐4 co‐infection during an epidemic in Rio de Janeiro, Brazil

Brote epidémico de dengue en la Ciudad de Buenos Aires, 2016: características clínicas y hematológicas de la infección en una población pediátrica

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