Martins Ezequias B, Quintana Marcel S B, Silva Michele F B, de Bruycker-Nogueira Fernanda, Moraes Isabella C V, Rodrigues Cintia D S, Santos Carolina C, Sampaio Simone A, Pina-Costa Anielle, Fabri Allison A, Guerra-Campos Vinícius, Faria Nieli R C, Filippis Ana Maria B, Brasil Patrícia, Calvet Guilherme A
Acute Febrile Illnesses Laboratory, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, Rio de Janeiro 21045-900, Brazil.
Clinical Research Platform, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil.
J Clin Virol. 2023 Dec;169:105610. doi: 10.1016/j.jcv.2023.105610. Epub 2023 Oct 8.
Chikungunya can cause persistent chronic joint pain. Knowledge of the risk factors for disease progression is important for preventing and controlling complications. This study aimed to identify factors associated with chronic joint pain.
This prospective cohort study was conducted at a reference center in Rio de Janeiro. Men and women (aged ≥ 18 years) in the acute phase of Chikungunya were included. Clinical data and samples were collected over three months. Risk factors were evaluated using multivariate and logistic regression analyses.
A total of 107 patients were followed up. The incidence rate of joint tenderness was 61.7 %. Female sex (adjusted odds ratio [AOR] 3.24, 95 % confidence interval [CI]:1.07-9.77), diarrhea (AOR 5.08, 95 % CI:1.55-16.67), severe joint pain (AOR 4.26, 95 % CI:1.06-17.06), and CHIKV real-time reverse transcription polymerase chain reaction positivity up to 5 days after the onset of symptoms in urine or saliva (AOR 4.56, 95 % CI:1.41-14.77) were identified as predictors of persistent chronic pain.
In a predominantly female population, musculoskeletal symptoms are not the sole determinant of chronic pain, and careful evaluation of CHIKV detection in alternative body fluids (such as saliva and urine) during the early phase of the disease is warranted.
基孔肯雅热可导致持续性慢性关节疼痛。了解疾病进展的风险因素对于预防和控制并发症很重要。本研究旨在确定与慢性关节疼痛相关的因素。
这项前瞻性队列研究在里约热内卢的一个参考中心进行。纳入基孔肯雅热急性期的男性和女性（年龄≥18岁）。在三个月内收集临床数据和样本。使用多变量和逻辑回归分析评估风险因素。
共对107例患者进行了随访。关节压痛的发生率为61.7%。女性（调整优势比[AOR]3.24，95%置信区间[CI]：1.07 - 9.77）、腹泻（AOR 5.08，95%CI：1.55 - 16.67）、严重关节疼痛（AOR 4.26，95%CI：1.06 - 17.06）以及症状出现后5天内尿液或唾液中基孔肯雅病毒实时逆转录聚合酶链反应呈阳性（AOR 4.56，95%CI：1.41 - 14.77）被确定为持续性慢性疼痛的预测因素。
在以女性为主的人群中，肌肉骨骼症状并非慢性疼痛的唯一决定因素，在疾病早期仔细评估替代体液（如唾液和尿液）中的基孔肯雅病毒检测情况是必要的。
