Gulati Shipra, Duggu Samrasimha Reddy, Chawla Kunal, Dessai Rishikesh, Jain Sunil
Department of Medicine, Sir Ganga Ram Hospital, New Delhi, India.
Ann Afr Med. 2024 Oct 1;23(4):563-566. doi: 10.4103/aam.aam_131_23. Epub 2024 Aug 13.
Chikungunya virus (CHIKV) and dengue fever have been reported for recent epidemics worldwide, with varied clinical involvement. Chikungunya was first reported to affect the nervous system in the 1960s. The clinical profile of dengue with multi-organ involvement is varied with reported involvement of the central nervous system in some.
The aim of this study was to study the frequency and pattern of neurological involvement in patients admitted with dengue and chikungunya in a tertiary care hospital.
Patients admitted with confirmed chikungunya and dengue were evaluated clinically and investigations were enrolled in the study. Patients with preexisting neurological issues, obvious metabolic, vascular, or septic causes for neurological involvement were excluded from the study.
A total of 309 patients with chikungunya were included in the study. Out of these, 11 (3.56%) patients were found to have neurological involvement. The most common presentations were altered sensorium (100%) followed by headache (81.81%). The relative risk of mortality in patients with neurological involvement due to chikungunya was 7.96. A total of 443 patients with dengue fever were enrolled in the study. Out of these, 5 (1.10%) patients were found to have neurological involvement. The most common presentations were altered sensorium and headache (100%), followed by vomiting (80%). The relative risk of mortality in patients with neurological involvement due to dengue was 5.15.
The recent epidemic of chikungunya and dengue virus infections was associated with various neurological complications. Neurological involvement of chikungunya and dengue was identified to be a bad prognostic factor with significantly higher mortality.
This is a single center study, involving only the patients admitted to the hospital. Furthermore, being an observational study, follow-up could not be done to look for neurological sequelae.
近期全球范围内报告了基孔肯雅病毒（CHIKV）和登革热的流行，临床表现各异。基孔肯雅热最早于20世纪60年代被报道可累及神经系统。登革热多器官受累的临床特征各不相同，部分病例报告显示中枢神经系统也会受累。
本研究旨在探讨一家三级护理医院中登革热和基孔肯雅热患者神经受累的频率和模式。
对确诊为基孔肯雅热和登革热的住院患者进行临床评估，并纳入研究进行调查。存在既往神经问题、明显的代谢、血管或感染性神经受累病因的患者被排除在研究之外。
本研究共纳入309例基孔肯雅热患者。其中，11例（3.56%）患者出现神经受累。最常见的表现是意识改变（100%），其次是头痛（81.81%）。基孔肯雅热神经受累患者的相对死亡风险为7.96。本研究共纳入443例登革热患者。其中，5例（1.10%）患者出现神经受累。最常见的表现是意识改变和头痛（100%），其次是呕吐（80%）。登革热神经受累患者的相对死亡风险为5.15。
近期基孔肯雅热和登革热病毒感染的流行与各种神经并发症相关。基孔肯雅热和登革热的神经受累被确定为不良预后因素，死亡率显著更高。
这是一项单中心研究，仅纳入了住院患者。此外，作为一项观察性研究，无法进行随访以寻找神经后遗症。
