Valenzuela Gonzalo, Barahona Katherine, Rojas Camila, Barrera Aldo, Henríquez Carolina, Martínez-Valdebenito Constanza, Potin Marcela, Bedregal Paula, Ferrés Marcela
Departamento de Enfermedades Infecciosas e Inmunología Pediátrica, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 8320165, Chile.
Laboratorio de Infectología y Virología Molecular, Red Salud UC-CHRISTUS, Santiago 8320165, Chile.
Viruses. 2025 Sep 15;17(9):1241. doi: 10.3390/v17091241.
Andes virus (ANDV) is the leading cause of hantavirus cardiopulmonary syndrome (HCPS) in South America, a severe zoonosis with high mortality. Advances in critical care and extracorporeal membrane oxygenation (ECMO) have significantly improved survival rates; however, data on recovery beyond survival remain limited. This multicenter cohort study enrolled laboratory-confirmed HCPS survivors in Chile between 2021 and 2024, with follow-up at 3-6 months post-symptom onset to assess physical and neuropsychological sequelae. Participants were stratified by ECMO requirement and the clinical severity of HCPS, and evaluated using self-reported recovery, standardized symptom questionnaires, and EQ-5D quality-of-life instruments. Among 21 survivors (11 ECMO, 10 non-ECMO), 61.9% reported incomplete recovery. While 60-70% of patients received general medical follow-up, only 30% of non-ECMO patients-compared to all ECMO patients-had contact with a rehabilitation provider. Motor dysfunction and palpitations were more frequent in ECMO survivors; however, Jaccard index analysis revealed clustering of physical and neuropsychological symptoms across both groups. EQ-5D assessments showed comparable quality-of-life impairment, though non-ECMO survivors more often reported pain/discomfort (90.0% vs. 63.6%) and higher rates of analgesic self-medication. These findings highlight the burden of persistent symptoms after HCPS and the need for multidisciplinary post-discharge care in endemic regions.
安第斯病毒（ANDV）是南美洲汉坦病毒心肺综合征（HCPS）的主要病因，HCPS是一种具有高死亡率的严重人畜共患病。重症监护和体外膜肺氧合（ECMO）技术的进步显著提高了生存率；然而，关于生存之外恢复情况的数据仍然有限。这项多中心队列研究纳入了2021年至2024年期间智利实验室确诊的HCPS幸存者，在症状出现后3至6个月进行随访，以评估身体和神经心理后遗症。参与者根据是否需要ECMO以及HCPS的临床严重程度进行分层，并使用自我报告的恢复情况、标准化症状问卷和EQ-5D生活质量工具进行评估。在21名幸存者中（11名使用ECMO，10名未使用ECMO），61.9%报告恢复不完全。虽然60%-70%的患者接受了常规医疗随访，但与所有使用ECMO的患者相比，只有30%未使用ECMO的患者与康复服务提供者有过接触。使用ECMO的幸存者中运动功能障碍和心悸更为常见；然而，雅卡尔指数分析显示两组在身体和神经心理症状方面存在聚类现象。EQ-5D评估显示生活质量受损程度相当，不过未使用ECMO的幸存者更常报告疼痛/不适（90.0%对63.6%），且自行服用镇痛药的比例更高。这些发现凸显了HCPS后持续症状的负担以及流行地区出院后多学科护理的必要性。
