Severe manifestations of chikungunya virus in critically ill patients during the 2013–2014 Caribbean outbreak

Abstract

Most patients admitted to the ICU with CHIKV infection had a pre-existing comorbidity. However, severe manifestations such as Guillain-Barré syndrome, encephalitis, and severe sepsis could be specifically related to CHIKV.

Three atypical lethal cases associated with acute Zika virus infection in Suriname

“…Additionally, mild (e.g., hypertension, diabetes mellitus) and severe (i.e., leukemia) co-morbidity was also present in these patients, indicating that such co-morbidities may predispose to a lethal outcome. Reports from Guadeloupe and Martinique and Venezuela on severe and lethal cases of chikungunya describe septic presentations in similar age groups with similar co-morbidities [13], [14] Additionally, in all three cases, potential acute myocardial infarction, evidenced by high CK (in all three) and CK-MB (in case 1 and 2) levels, may have been excacerbated by acute ZIKV infection, for which these patients may have been prone due to their pre-existing conditions. However, ECG did not show evidence of myocardial infarction.…”

“…Laboratory results show evidence for activation of acute and innate immune responses (Table 1), similarly seen in severe, mostly secondary, cases of dengue fever, and in cases of chikungunya [13], [14], [22]. Indeed, especially dengue is known to cause an intravascular ‘cytokine storm’ associated with increased vascular permeability, which may result in potentially lethal dengue shock syndrome [23].…”

The neurological complications of chikungunya virus: A systematic review

“…As well as neurological manifestations, chikungunya virus is associated with complications of the cardiovascular, renal, respiratory, hepatic, gastrointestinal, and adrenal systems, sometimes collectively referred to as “atypical features.” However, a disorder of the nervous system appears to be the most common severe complication of chikungunya infection (Table ). In 2 studies investigating manifestations of chikungunya in patients requiring intensive care, a neurological disorder was the primary issue in 61% and 79% of chikungunya‐infected patients.…”

Prevalence of chronic comorbidities in chikungunya: A systematic review and meta-analysis

“…Ten articles were excluded at the full text review stage as they were either not related to the study objectives (4 studies), not reporting prevalence of chronic disease in CHIKV (3 studies), case reports with small numbers of cases (i.e., <3 cases; 2 reports), or a review article (see Figure 1 and Supplementary Table S1). After identifying one study through bibliography searching, 11 reports were included for systematic review and meta-analysis (Arroyo-Avila et al, 2017;Economopoulou et al, 2009;Padmakumar et al, 2010;Jean-Baptiste et al, 2016;Sá deOliveira et al, 2017;Perti et al, 2016;Crosby et al, 2016;Chusri et al, 2014;Couturier et al, 2012;Tandale et al, 2009;Borgherini et al, 2007).…”