Persistence of symptoms in dengue patients: a clinical cohort study
| Autor: | José Ramos-Castañeda, Diana Carolina Tiga-Loza, Donald S. Shepard, Eduardo A. Undurraga, Ruth Aralí Martínez-Vega, Cynthia A. Tschampl |
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| Rok vydání: | 2020 |
| Předmět: |
Abdominal pain
medicine.medical_specialty Fever Clinical cohort media_common.quotation_subject 030231 tropical medicine Dengue fever Persistence (computer science) Cohort Studies Dengue 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans 030212 general & internal medicine Mexico media_common Platelet Count business.industry Convalescence Public Health Environmental and Occupational Health General Medicine medicine.disease Infectious Diseases Ambulatory Symptom persistence Parasitology medicine.symptom business Cohort study |
| Zdroj: | Transactions of The Royal Society of Tropical Medicine and Hygiene. 114:355-364 |
| ISSN: | 1878-3503 0035-9203 |
| DOI: | 10.1093/trstmh/traa007 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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