Impact of Q-fever on physical and psychosocial functioning until 8 years after Coxiella burnetii infection: An integrative data analysis

Abstract

Background This study aimed to determine short- and long-term physical and psychosocial impact of Coxiella burnetii infection in three distinct entities: Q-fever fatigue syndrome (QFS), chronic Q-fever, and patients with past acute Q-fever without QFS or chronic Q-fever. Methods Integrative data analysis was performed, combining original data from eight studies measuring quality of life (QoL), fatigue, physical and social functioning with identical validated questionnaires, from three months to eight years after onset infection. Linear trends in each outcome were compared between Q-fever groups using multilevel linear regression analyses to account for repeated measures within patients. Results Data included 3947 observations of 2313 individual patients (228 QFS, 135 chronic Q-fever and 1950 patients with past acute Q-fever). In the first years following infection, physical and psychosocial impact was highest among QFS patients, and remained high without significant improvements over time. In chronic Q-fever patients, QoL and physical functioning worsened significantly over time. Levels of fatigue and social participation in patients with past acute Q-fever improved significantly over time. Conclusion The impact differs greatly between the three Q-fever groups. It is important that physicians are aware of these differences, in order to provide relevant care for each patient group.

Sir Michael George Parke Stoker. 4 July 1918—13 August 2013

“…This observation also had a practical implication in the specificity of diagnostic tests, because the early passage egg-grown antigen could yield false-negative results. Although Michael left the Rickettsia field in the mid 1950s, human Q fever infection continues to be an important veterinary and human health problem; for instance, there was a large human outbreak in The Netherlands in 2017 (Reukers et al 2022).…”

Macrophage infectivity potentiator protein, a peptidyl prolyl cis-trans isomerase, essential for Coxiella burnetii growth and pathogenesis

“…Once persistent C. burnetii infection is diagnosed, the prescribed treatment is a combination of doxycycline and hydroxychloroquine lasting 18 or more months. Furthermore, approximately 20% of patients who recover from acute infection suffer for years from chronic fatigue, a condition known as Q fever fatigue syndrome that can severely impact their quality of life [9][10][11][12]. An effective human vaccine is available, (Q-VAX, Seqirus Australia), but it is only licenced in Australia and requires prevaccination screening as there are severe adverse reactions to the vaccine if the individual has immunity as a result of previous exposure to C. burnetii [13].…”