Persistence of symptoms in dengue patients: a clinical cohort study.

Autor:	Tiga-Loza DC; Programa de enfermería, Universidad Manuela Beltrán, Bucaramanga, Santander, Colombia.; Centro de investigaciones sobre enfermedades infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México., Martínez-Vega RA; Escuela de Microbiología, Universidad Industrial de Santander, Bucaramanga, Santander, Colombia., Undurraga EA; Escuela de Gobierno, Pontificia Universidad Católica de Chile, Santiago, Chile.; Millennium Nucleus for the Study of the Life Course and Vulnerability (MLIV), Chile., Tschampl CA; Schneider Institutes for Health Policy, Heller School, Brandeis University, Waltham, Massachusetts, USA., Shepard DS; Schneider Institutes for Health Policy, Heller School, Brandeis University, Waltham, Massachusetts, USA., Ramos-Castañeda J; Centro de investigaciones sobre enfermedades infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.; Universidad Anahuac, Centro de Investigación en Ciencias de la Salud. México.
Jazyk:	angličtina
Zdroj:	Transactions of the Royal Society of Tropical Medicine and Hygiene [Trans R Soc Trop Med Hyg] 2020 May 07; Vol. 114 (5), pp. 355-364.
DOI:	10.1093/trstmh/traa007
Abstrakt:	Background: Dengue is commonly considered an acute illness and follows three phases: febrile, critical in some cases and recovery. However, a number of studies have described a continuation of dengue symptoms for weeks or months, extending the recovery phase. Here we evaluate this persistence of dengue symptoms during convalescence. Methods: Our clinical cohort study included patients who sought medical services 48 to 144 h from the onset of fever at seven hospitals or ambulatory centers in Morelos, Mexico. Seventy-nine laboratory-confirmed dengue patients were followed up regularly using clinic and/or home visits and telephone calls for as long as symptoms persisted or up to 6 mo. Results: In total, 55.7% of patients had dengue-related symptoms 1 mo after the onset of fever; pain and dermatological manifestations were the most common persistent symptoms. Prognostic factors for symptom persistence were: ≥4 d of fever (RR 1.72; 95% CI 1.35 to 2.19), platelet count ≤100 000/mm3 (RR 1.20; 95% CI 1.20 to 2.20), petechiae/bruises (RR 1.97; 95% CI 1.56 to 2.48) and abdominal pain/hepatomegaly (RR 1.79; 95% CI 1.41 to 2.28). Conclusions: Persistence of dengue symptoms were common in laboratory-confirmed dengue patients. Manifestations related to tissue damage were associated with persistence after 30 d; host characteristics, such as age and health status before infection, were associated with prolonged persistence (>60 d). The burden of dengue may be higher than previously estimated. (© The Author(s) 2020. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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