Impact of Chronic Kidney Disease on Chikungunya Virus Infection Clinical Manifestations and Outcome: Highlights during an Outbreak in Northeastern Brazil

Silva, Geraldo Bezerra da; Pinto, José; Mota, Rosa Maria Salani; Neto, Roberto da Justa Pires; Daher, Elizabeth De Francesco

doi:10.4269/ajtmh.18-0531

Cited by 16 publications

(15 citation statements)

References 24 publications

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“…Although most patients with chikungunya admitted to hospital (~80% in one study 10 ) do not have severe symptoms, many patients have atypical manifestations that can become severe and/or have chikungunya complicated by co-infections and/or comorbidities. Hospitalization rates for patients with chikungunya have varied from 0.6% (Martinique and Guadeloupe 10 ), through 2.3% (Réunion Island 11 ), 3.3% (Brazil 12 ) and 6% (India 13 ) to 13% (Puerto Rico 14 ). The mean length of hospital stay reported for these patients was 5 days (SD ±7 days; range 0-146 days) in Réunion Island 11 and 9 days (range 0-46 days) in Martinique and Guadeloupe 10 .…”

Section: Atypical Acute Chikungunyamentioning

confidence: 99%

“…The presence of comorbidities is also associated with increased morbidity. For example, in a cross-sectional study of a chikungunya outbreak in north-eastern Brazil, 1% of patients with chikungunya had chronic kidney disease (amongst other comorbidities that included diabetes, haematological disorders, liver disease, hypertension and autoimmune diseases); these patients had higher frequencies of the main acute manifestations of chikung unya and higher mortality than patients without chronic kidney disease 12 . In another study of 65 patients with chikungunya who were admitted to ICUs in Martinique and Guadeloupe, 83% had pre-existing underlying comorbidities (hypertension, diabetes, renal disease, cardiac disease or autoimmune disease, including systemic lupus erythematosus) and the mortality rate among these patients was 27% 62 .…”

Section: Comorbidities and Co-infections Comorbiditiesmentioning

confidence: 99%

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Rheumatic manifestations of chikungunya: emerging concepts and interventions

Suhrbier

2019

Nat Rev Rheumatol

145

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Chikungunya virus (CHIKV) is a member of a group of globally distributed, mosquito-transmitted arthritogenic alphaviruses that cause sporadic outbreaks of primarily rheumatic disease every 2-50 years 1-4. The largest epidemic of CHIKV disease (hereafter simply referred to as chikungunya) ever recorded began on Lamu Island, Kenya, in 2004 (Fig. 1). The epidemic expanded across four continents, with cases still being reported in 2019 (Fig. 1; Supplementary Table 1). Three major genotypes of CHIKV are now recognized-the Asian, the West African and the Asian and East-Central South African (ECSA) genotypes 5-but a new lineage, the Indian Ocean Lineage (IOL), also emerged from the ECSA genotype during the 2004-2019 epidemic 6. The epidemic reached >100 countries (Supplementary Table 1), caused >10 million cases (Supplementary Table 2), and might arguably be called a pandemic. An estimated 1.3 billion people are at risk of chikungunya 7. Climate change modelling suggests that many more areas of the world (including parts of China, sub-Saharan Africa, South America and the United States) might become able to accommodate transmission of CHIKV in the future 8,9. Chikungunya was previously often viewed as (and for many patients remains) a relatively benign and selflimiting rheumatic disease. However, a considerably more complex spectrum of less common atypical and severe manifestations is now recognized in subgroups of patients, with chikungunya often complicated by comorbidities and co-infections. Hospitalization rates for chikun gunya range from 0.6% to 13% 10-14 and estimates of chikungunya-related mortality range from 0.024% to 0.7% 10,12,15-17. In addition, many patients develop protracted rheumatic disease lasting many months, occasionally years, with a number of sequelae now also recognized 18-22. Estimates for the total economic costs (direct and indirect) of chikungunya have ranged from a median of US$67 for adults and $258 for children in Columbia 23 , to a mean of $150 per outpatient and $3,300 per inpatient in 2006 in Réunion Island 11. In a large study of a chikungunya outbreak in Bangladesh in 2017, >10 days of productivity were lost in ~30% of patients with chikung unya because of severe arthropathy 24. Such costs might be viewed as relatively modest by Western standards; however, the occasionally high attack rate of chikungunya, with up to 30-75% of a given population affected by chikungunya disease at any one time 1,25 , can result in a substantial economic burden, especially in resource-poor communities that are often affected by the disease 26. Considerable research in patients and animal models has now provided extensive insights into the complex Pandemic An epidemic of disease that has spread across a large region; for instance, multiple continents, or even worldwide. Attack rate The total number of new cases of a disease divided by the total population (that is, the percentage of a defined population that is affected by a disease).

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Section: Atypical Acute Chikungunyamentioning

confidence: 99%

Section: Comorbidities and Co-infections Comorbiditiesmentioning

confidence: 99%

Rheumatic manifestations of chikungunya: emerging concepts and interventions

Suhrbier

2019

Nat Rev Rheumatol

145

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“…Although CHIKF is known as a non-deadly disease, atypical and severe acute manifestations can evolve to multiple organ failure and death. Mortality rates can range from 0.024 up to 0.7% and seem to depend on both the virus genotype/strain and the commitment of neurological system (Jaffar-Bandjee et al, 2010;de Brito, 2017;Dorléans et al, 2018;Freitas et al, 2018;da Silva et al, 2018;Suhrbier, 2019).…”

Section: Introductionmentioning

confidence: 99%

Overview on Chikungunya Virus Infection: From Epidemiology to State-of-the-Art Experimental Models

Constant

Rajsfus²,

Carneiro³

et al. 2021

Front. Microbiol.

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Chikungunya virus (CHIKV) is currently one of the most relevant arboviruses to public health. It is a member of the Togaviridae family and alphavirus genus and causes an arthritogenic disease known as chikungunya fever (CHIKF). It is characterized by a multifaceted disease, which is distinguished from other arbovirus infections by the intense and debilitating arthralgia that can last for months or years in some individuals. Despite the great social and economic burden caused by CHIKV infection, there is no vaccine or specific antiviral drugs currently available. Recent outbreaks have shown a change in the severity profile of the disease in which atypical and severe manifestation lead to hundreds of deaths, reinforcing the necessity to understand the replication and pathogenesis processes. CHIKF is a complex disease resultant from the infection of a plethora of cell types. Although there are several in vivo models for studying CHIKV infection, none of them reproduces integrally the disease signature observed in humans, which is a challenge for vaccine and drug development. Therefore, understanding the potentials and limitations of the state-of-the-art experimental models is imperative to advance in the field. In this context, the present review outlines the present knowledge on CHIKV epidemiology, replication, pathogenesis, and immunity and also brings a critical perspective on the current in vitro and in vivo state-of-the-art experimental models of CHIKF.

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Section: Introductionmentioning

confidence: 99%

“…In addition to nonmicrobial renal diseases, several renal abnormalities are associated with viral infections such as Hepatitis C virus causing glomerular nephropathies such as glomerular sclerosis and membranoproliferative glomerulonephritis (Azmi, Tan, & Mohamed, 2015;Long, Rutledge, & Sise, 2018). HIV virus is also reported with pain, kidney injury and other renal complications, along with the risk of developing other types of viral infections such as ones caused by parvovirus, BK-virus, adenovirus, cytomegalovirus, and chikungunya virus, seen in histological studies (Silva Junior, Pinto, Mota, Pires Neto, & Daher, 2018;Waldman, Marshall, Whitby, & Kopp, 2008). This review is designed to discuss analgesic-associated pain management is several renal conditions, where pain persists in a higher degree; such as nephrolithiasis, postoperative use of analgesics and their renal effects and genetic conditions that affect the pharmacokinetics of these drugs leading to a difference in drugsbased response.…”

mentioning

confidence: 99%

Renal impairment and analgesia: From effectiveness to adverse effects

Alizadeh

Fard

2019

Journal Cellular Physiology

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Kidney pain is one of the clinically significant features of renal dysfunction. Mild to severe pain is seen in the lower back area. Painkillers are mostly recommended in these cases to relieve the symptom. Yet, several analgesics are associated with side effects that can worsen the state of the disease. This review is based on the studies conducted in these aspects analgesics used to treat kidney pain and their effectiveness, renal consequences of postoperative analgesia, and pharmacogenetics of these palliatives are briefly summarized in this paper.

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Impact of Chronic Kidney Disease on Chikungunya Virus Infection Clinical Manifestations and Outcome: Highlights during an Outbreak in Northeastern Brazil

Cited by 16 publications

References 24 publications

Rheumatic manifestations of chikungunya: emerging concepts and interventions

Rheumatic manifestations of chikungunya: emerging concepts and interventions

Overview on Chikungunya Virus Infection: From Epidemiology to State-of-the-Art Experimental Models

Renal impairment and analgesia: From effectiveness to adverse effects

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