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Background: Chikungunya virus (CHIKV) is a reemergent arbovirus from the Alphavirus genus transmitted by Aedes species mosquitoes. The main feature of CHIKV disease is severe polyarthralgia, which is reported in more than 90% of cases. Musculoskeletal symptoms may persist in the subacute (> 3 weeks) and chronic (> 12 weeks) phases, causing critical physical impairment and significantly impacting the quality of life of patients. Objectives: To assess the impact of CHIKV on pain, functional status, work ability and health-related quality of life (HRQoL) in the subacute and chronic phases of the disease. Methods: Patients with a diagnosis of CHIKV disease (confirmed by PCR or serology) with persistent musculoskeletal symptoms after 4 weeks were referred to the Rheumatology outpatient clinic and followed up from April 2018 to January 2019. Evaluation questionnaires of pain (visual analogue scale – VAS), disability (Health Assessment Questionanaire – HAQ), HRQOL (Short-form 12 – SF-12) and work ability (Work Productivy and Activity Impairment-WPAI) were applied. The assessments were divided into 3 stages according to the time of disease: subacute from 4 to 12 weeks, chronic from 12 to 24 weeks and chronic with more than 24 weeks. Results: Of the 69 patients analyzed, 76.81% were women, mean age 49.78 ± 14.24 years, 49.27% had some comorbidity (such as hypertension and diabetes), 26 were obese and 37.68% presented a previous musculoskeletal condition. Fifty-eight patients initiated follow-up in the subacute phase, in which the average pain was 6.84±1.9, mean HAQ of 1.59±0.57, mean Physical Health Composite Scale Score (PCS) of 26.81±14.3 and Mental Health Composite Scale Score (MCS) of 36.77±15.9. Of the 58 patients, 35 were employed and of these, 54.25% were absent from work during the previous week. Women presented lower scores in the mental component of SF-12 (p=0.0215) and the presence of comorbidity was related to higher values reported in the pain VAS (p = 0.026). In the chronic phase of 12-24 weeks, 50 patients were evaluated, with mean pain 5.27 ± 2.22, HAQ 1.16 ± 0.61, PCS of 38.82±17.26 and MCF 43.72±17.13). Thirty-two patients were employed, of which 25% were absent the antecedent week. During this stage, women presented lower values of MCS (p = 0.0245) and the presence of obesity was related to higher values in HAQ (p=0.0157). Finally, in the evaluation of the chronic phase after 24 weeks of evolution, we included 25 patients with the mean of pain 5.64 ± 2.3, HAQ 1.11 ± 0.49, PCS 36.72±19 and MCS 41.56±17.74. Fifteen of the 25 patients were employed and 33% were absent from work the previous week. There was no significant difference between the groups evaluated after 6 months of evolution. Conclusion: In this study, we demonstrated that the impact of chikungunya persists after 1 month of evolution in a large number of patients. The incapacity for work caused by the disease, represented by persistent rates of absenteeism at work in an economically active age group, further aggravates the magnitude of the problem. References [1] Couturier, E., Guillemin, F., Mura, et.al. Impaired quality of life after chikungunya virus infection: a 2-year follow-up study. Rheumatology. 2012Jul; 51(7), 1315–22. [2] Soumahoro, M.-K., Gerardin, P., Boelle, P.-Y. Et al. Impact of Chikungunya Virus Infection on Health Status and Quality of Life: A Retrospective Cohort Study. PLoS ONE. 2009Nov; 4(11), e7800. Disclosure of Interests: None declared |
