Corneliu Petru Popescu1, Simin Aysel Florescu2, Rodrigo Hasbun3, Arjan Harxhi4, Razi Evendar5, Hasip Kahraman6, Ami Neuberger5, Daniel Codreanu7, Mihaela Florentina Zaharia8, Selma Tosun9, Emanoil Ceausu7, Simona Maria Ruta10, Gorana Dragovac11, Natalia Pshenichnaya12, Galina Gopatsa13, Olga Shmaylenko14, Éva Nagy15, Jelena Djekic Malbasa11, Mirjana Strbac16, Nenad Pandak17, Husnu Pullukcu6, Botond Lakatos15, Yasemin Cag18, Antonio Cascio19, Ilaria Coledan20, Serkan Oncu21, Hakan Erdem22. 1. University of Medicine and Pharmacy Carol Davila Bucharest, Romania; Dr Victor Babes Clinical Hospital of Infectious and Tropical Diseases Bucharest, Romania; ESCMID Study Group for Infectious Diseases of the Brain - ESGIB, Switzerland. Electronic address: corneliu.popescu@umfcd.ro. 2. University of Medicine and Pharmacy Carol Davila Bucharest, Romania; Dr Victor Babes Clinical Hospital of Infectious and Tropical Diseases Bucharest, Romania. 3. Department of Infectious Diseases, UT Health McGovern Medical School, Houston, TX, USA. 4. Service of Infectious Disease, University Hospital Center of Tirana, Tirana, Albania. 5. Infectious Diseases Institute, Rambam Health Care Campus, Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel. 6. Ege University, School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Izmir, Turkey. 7. Dr Victor Babes Clinical Hospital of Infectious and Tropical Diseases Bucharest, Romania. 8. University of Medicine and Pharmacy Carol Davila Bucharest, Romania; Dr Victor Babes Clinical Hospital of Infectious and Tropical Diseases Bucharest, Romania; ESCMID Study Group for Infectious Diseases of the Brain - ESGIB, Switzerland. 9. Department of Infectious Diseases and Clinical Microbiology, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey. 10. University of Medicine and Pharmacy Carol Davila Bucharest, Romania; Stefan S. Nicolau Institute of Virology, Bucharest, Romania. 11. Institute of Public Health of Vojvodina, Department of Prevention and Control of Diseases, Novi Sad, Serbia; University of Novi Sad, Faculty of Medicine, Department of Epidemiology, Novi Sad, Serbia. 12. National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Moscow, Russia; Central Scientific Research Laboratory, Rostov State Medical University, Rostov-on-Don, Russia. 13. Department of Infectious Diseases, Rostov State Medical University, Rostov-on-Don, Russia. 14. Department of Infectious Diseases #5, City Hospital #1 named after N.A. Semashko, Rostov-on-Don, Russia. 15. National Institute of Hematology and Infectious Diseases, Saint Laszlo Hospital, Budapest, Hungary. 16. Institute of Public Health of Vojvodina, Department of Prevention and Control of Diseases, Novi Sad, Serbia. 17. General Hospital Slavonski Brod, Department for Infectious Diseases, School of Medicine, University of Split, Split, Croatia. 18. Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey. 19. Section of Infectious and Tropical Diseases, Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Italy. 20. Department of Diagnostics and Public Health, Section of Infectious Diseases, University of Verona, Verona, Italy. 21. Department of Infectious Diseases and Clinical Microbiology, Adnan Menderes University School of Medicine, Aydin, Turkey. 22. ESCMID Study Group for Infectious Diseases of the Brain - ESGIB, Switzerland; ID-IRI, Ankara, Turkey.
Abstract
BACKGROUND: WNV causes 1.4% of all central nervous system infections and is the most common cause of epidemic neuro-invasive disease in humans. OBJECTIVES: Our main objective was to investigate retrospectively West Nile virus neuroinvasive disease (WNND) cases hospitalized during 2010-2017 and identified factors that can influence prognosis. STUDY DESIGN: We documented the demographic, epidemiologic, clinical and laboratory data of WNND and identified factors that can influence prognosis. The data were recruited through Infectious Diseases International Research Initiative (ID-IRI), which serves as a network for clinical researches. RESULTS: We investigated 165 patients with WNND in 10 countries from three continents. 27 patients died and the mortality rate was 16.4%. In an univariate analysis age, congestive heart failure, neoplasm and ischemic heart disease (p < 0.001), neuropsychiatric disorders (p = 0.011), chronic hepatitis (p = 0.024) and hypertension (p = 0.043) were risk factors for death. Fatal evolution was also correlated with ICU addmission, disorientation, speech disorders, change in consciousnes, coma, a low Glasgow coma score, obtundation, confusion (p < 0.001), history of syncope (p = 0.002) and history of unconsciousness (p = 0.037). In a binomial logistic regresssion analysis only age and coma remained independent prediction factors for death. We created an equation that was calculated according to age, co-morbidities and clinical manifestations that may be used to establish the prognosis of WNND patients. CONCLUSIONS: WNND remain an important factor for morbidity and mortality worldwide, evolution to death or survival with sequelae are not rare. Our study creates an equation that may be used in the future to establish the prognosis of WNND patients.
BACKGROUND: WNV causes 1.4% of all central nervous system infections and is the most common cause of epidemic neuro-invasive disease in humans. OBJECTIVES: Our main objective was to investigate retrospectively West Nile virus neuroinvasive disease (WNND) cases hospitalized during 2010-2017 and identified factors that can influence prognosis. STUDY DESIGN: We documented the demographic, epidemiologic, clinical and laboratory data of WNND and identified factors that can influence prognosis. The data were recruited through Infectious Diseases International Research Initiative (ID-IRI), which serves as a network for clinical researches. RESULTS: We investigated 165 patients with WNND in 10 countries from three continents. 27 patients died and the mortality rate was 16.4%. In an univariate analysis age, congestive heart failure, neoplasm and ischemic heart disease (p < 0.001), neuropsychiatric disorders (p = 0.011), chronic hepatitis (p = 0.024) and hypertension (p = 0.043) were risk factors for death. Fatal evolution was also correlated with ICU addmission, disorientation, speech disorders, change in consciousnes, coma, a low Glasgow coma score, obtundation, confusion (p < 0.001), history of syncope (p = 0.002) and history of unconsciousness (p = 0.037). In a binomial logistic regresssion analysis only age and coma remained independent prediction factors for death. We created an equation that was calculated according to age, co-morbidities and clinical manifestations that may be used to establish the prognosis of WNND patients. CONCLUSIONS: WNND remain an important factor for morbidity and mortality worldwide, evolution to death or survival with sequelae are not rare. Our study creates an equation that may be used in the future to establish the prognosis of WNND patients.