Cohort study: Neurological and cognitive-behavioral sequelae of acquired Zika virus infection among Nicaraguan children.

Autor: Lebov JF; Social, Statistical, and Environmental Sciences, RTI International, Durham, NC, USA. jlebov@rti.org., LaForett DR; FPG Child Development Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Gajewski A; Sustainable Sciences Institute, Managua, Nicaragua., Browne EN; Social, Statistical, and Environmental Sciences, RTI International, Durham, NC, USA., Zambrana JV; Sustainable Sciences Institute, Managua, Nicaragua.; Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA., Balmaseda A; Sustainable Sciences Institute, Managua, Nicaragua.; Laboratorio Nacional de Virología, Centro Nacional de Diagnósis y Referencia, Ministerio de Salud, Managua, Nicaragua., Harris E; Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA., Hooper SR; Department of Health Sciences, School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA. stephen_hooper@med.unc.edu.
Jazyk: angličtina
Zdroj: Pediatric research [Pediatr Res] 2024 Jul 02. Date of Electronic Publication: 2024 Jul 02.
DOI: 10.1038/s41390-024-03160-0
Abstrakt: Background: ZIKV has neuroinvasive properties, and in utero exposure can cause birth defects, but little is known about the neurological and neurocognitive impacts of acquired ZIKV infection, particularly in children.
Methods: We assessed neurological symptoms frequency among ZIKV-infected children within one year after ZIKV infection. Three to 5 years post-infection, these children and a matched group of uninfected children were assessed via questionnaires, neurological exams, and neuropsychological testing to evaluate the association between prior ZIKV infection and subsequent neurological symptoms, and cognitive-behavioral function.
Results: Among 194 ZIKV-infected children, 3 reported asthenia, 4 reported neck pain, and 10 reported back pain within one year post-infection. At follow-up, clinician-observed cranial nerve abnormalities were significantly more common among ZIKV-infected vs. uninfected children (16 vs. 3; p < 0.01), with vestibulocochlear nerve abnormalities observed most frequently. While ZIKV-infected children scored better than uninfected on cognitive measures, this difference was not clinically meaningful.
Conclusions: Neurological signs, including paresthesia and cranial nerve abnormalities, were observed among ZIKV-infected participants in our study. However, we did not observe a meaningful link between acquired ZIKV infection and subsequent neurological, cognitive, or behavioral outcomes in a representative sample. An exception may be hearing impairment and loss, which should be explored further in future studies.
Impact: Neurological symptoms, though rare, were observed and reported more frequently among ZIKV-infected vs. uninfected children. These included: asthenia, neck pain, back pain, paresthesia, and cranial nerve abnormalities. Neurocognitive and behavioral test scores were similar among ZIKV-infected and uninfected children. Our study suggests that ZIKV-infected children should be monitored for neurological symptoms and cranial neuropathy to better understand the full burden of acquired ZIKV infection among children.
(© 2024. The Author(s).)
Databáze: MEDLINE
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