Bampali Maria, Konstantinidis Konstantinos, Kellis Emmanouil E, Pouni Theodoti, Mitroulis Ioannis, Kottaridi Christine, Mathioudakis Alexander G, Beloukas Apostolos, Karakasiliotis Ioannis
Laboratory of Biology, Department of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece.
First Department of Internal Medicine, Democritus University of Thrace, University General Hospital of Alexandroupolis, 68100 Alexandroupolis, Greece.
Trop Med Infect Dis. 2022 Sep 8;7(9):236. doi: 10.3390/tropicalmed7090236.
West Nile virus (WNV) is a mosquito-borne flavivirus that has emerged as a major cause of viral encephalitis and meningitis, rarely leading to death. Several risk factors have been discussed in the past concerning the severity of the disease, while few reports have focused on precipitating conditions that determine of WNV-related death. Studies on cohorts of patients suffering of West Nile disease (WND) usually encompass low numbers of deceased patients as a result of the rarity of the event. In this systematic review and critical analysis of 428 published case studies and case series, we sought to evaluate and highlight critical parameters of WND-related death. We summarized the symptoms, comorbidities, and treatment strategies related to WND in all published cases of patients that included clinical features. Symptoms such as altered mental status and renal problems presented increased incidence among deceased patients, while these patients presented increased cerebrospinal fluid (CSF) glucose. Our analysis also highlights underestimated comorbidities such as pulmonary disease to act as precipitating conditions in WND, as they were significantly increased amongst deceased patients. CSF glucose and the role of pulmonary diseases need to be revaluated either retrospectively or prospectively in WND patient cohorts, as they may be linked to increased mortality risk.
西尼罗河病毒（WNV）是一种由蚊子传播的黄病毒，已成为病毒性脑炎和脑膜炎的主要病因，很少导致死亡。过去已经讨论了几个与疾病严重程度相关的风险因素，而很少有报告关注决定WNV相关死亡的诱发条件。由于西尼罗河病（WND）事件罕见，对WND患者队列的研究通常纳入的死亡患者数量较少。在对428篇已发表的病例研究和病例系列进行的系统评价和批判性分析中，我们试图评估并突出WND相关死亡的关键参数。我们总结了所有已发表的包含临床特征的患者病例中与WND相关的症状、合并症和治疗策略。精神状态改变和肾脏问题等症状在死亡患者中的发生率增加，而这些患者的脑脊液（CSF）葡萄糖水平升高。我们的分析还强调了被低估的合并症，如肺部疾病，它们在WND中作为诱发条件，因为在死亡患者中显著增加。CSF葡萄糖水平和肺部疾病的作用需要在WND患者队列中进行回顾性或前瞻性重新评估，因为它们可能与死亡风险增加有关。
