The Unknown Health Burden of Herpes Zoster Hospitalizations: The Effect on Chronic Disease Course in Adult Patients ≥50 Years

Abstract

The effect of severe Herpes Zoster (HZ) on chronic diseases is a component of the real burden of this vaccine-preventable disease that is not commonly considered. A retrospective cohort study was conducted to assess the health burden of severe HZ in adults ≥50 years residing in Liguria Region from 2015 to 2017. Subjects hospitalized with and without HZ were matched (1:6 ratio). 437 subjects in the HZ cohort and 2622 subjects in the non-HZ cohort were enrolled. Previous immunodeficiency, autoimmune, and rare diseases are identified as main chronic conditions related to HZ hospitalization. Higher incidences of autoimmune (1.4% vs. 0.22%, p = 0.002) and gastrointestinal (7.04% vs. 3.62%, p = 0.015) diseases after hospitalization were observed in the HZ cohort compared to the non-HZ cohort. Significantly higher incidences were found after hospitalization versus the previous period for cardiovascular diseases (11.17% vs. 2.09%, p < 0.001), cerebral vasculopathy (6.13% vs. 0.60%, p < 0.001), non-arrhythmic myocardiopathy (4.31% vs. 0.59%, p = 0.002), and neuropathy (2.62% vs. 0.56%, p = 0.033). The HZ cohort showed a relative risk 10-fold higher for cerebral vasculopathy, 5-fold higher for cardiovascular diseases, and 7-fold higher for non-arrhythmic myocardiopathy. HZ causes a substantial impact on the chronic conditions. These data could suggest an implementation of HZ vaccination programs in the elderly and in high-risk groups.

Has Clinical and Epidemiological Varicella Burden Changed over Time in Children? Overview on Hospitalizations, Comorbidities and Costs from 2010 to 2017 in Italy

“…The comparison between comorbidities revealed that broncopneumopathy and cardiovascular disease were the comorbidities most implicated in ED access/hospitalization for varicella than the other comorbidities; however, statistical significance was reached only for broncopneumopathy. Others studies have found analogous results [29,30].…”

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“…The mean age of patients with HZ hospitalized in the literature was between 63.6-80 years and the majority of the patients were over 60 years old. [7][8][9][10][11] Our results were compatible with earlier researches. The mechanism that causes this is thought to be the decrease in cellular immunity associated with VZV with increasing age.…”

Adult preventive vaccines with other synergistic lifestyle options: is it time to add these ancillary benefits to the overall AS management checklist?

“…Observational research continues to suggest the acute and chronic inflammation resulting from shingles and other vaccine preventable infections could also create an abnormal vascular milieu, which could, at least temporarily, increase the risk of various cardiovascular events including myocardial infarction and stroke [ 17 – 22 ]. For example, the consistent clinical research suggestive of an increased risk of transient ischemic attack (TIA) or stroke with herpes zoster ophthalmicus (HZO) continues to imply the greater the severity of the infection then the subsequent greater risk of an ancillary cardiovascular event.…”