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Events preceding death among chikungunya virus infected patients: a systematic review.

  • Cerbino-Neto, José1
  • Mesquita, Emersom Cicilini2
  • Amancio, Rodrigo Teixeira1, 3
  • do Brasil, Pedro Emmanuel Alvarenga Amer...1
  • 1 Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil.
  • 2 Faculdade de Medicina, Universidade Estácio de Sá, Rio de Janeiro, RJ, Brasil.
  • 3 Hospital Federal dos Servidores do Estado, Rio de Janeiro, RJ, Brasil.
Published Article
Revista da Sociedade Brasileira de Medicina Tropical
Sociedade Brasileira de Medicina Tropical - SBMT
Publication Date
May 11, 2020
DOI: 10.1590/0037-8682-0431-2019
PMID: 32401863
PMCID: PMC7269536
PubMed Central
  • Review Article


Since its re-emergence in the late 1990s, there have been reports of Chikungunya fever (CHIK-F) presenting with severe or atypical findings. There is little knowledge regarding the clinical events leading to the death of patients with CHIK-F. This study aimed to systematically review the literature regarding CHIK-F and identify clinical features preceding death. We searched PubMed, Scopus, Embase, Lilacs, and IsiWeb for case-reports, case-series, or cohorts of CHIK-F reporting at least one death, up to December 2019. Fifty-seven reports were analyzed, including 2140 deaths. Data about specific clinical events that precede death are scarce. The central tendency of time between disease onset and death ranged from 2 days to 150 days. The most common clinical findings among decedents were fever (22.0%), arthralgia (15.7%), myalgia (10.7%), and headache (8.2%). Excluding pediatric populations, the reported central tendency of age among the decedents was 53 or older, with a non-weighted median of 67, ranging up to 80 years old. Authors mentioned organic dysfunction in 91.2% reports. Among all the 2140 decedents, the most common dysfunctions were cardiovascular (7.2%), respiratory (6.4%), neurological (5.4%), renal (4.2%), liver (3.0%), and hematological (1.3%) dysfunction. Exacerbation of previous diabetes (5.6%) or hypertension (6.9%) was mentioned as conditions preceding death. Currently, older age, primary neurological, cardiovascular, or respiratory dysfunction and a previous diagnosis of diabetes or hypertension are the main clinical events preceding death.

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