Prediction of unfavorable outcomes in West Nile virus neuroinvasive infection – Result of a multinational ID-IRI study

Antonio Cascio, Husnu Pullukcu, Corneliu Petru Popescu, Mihaela Florentina Zaharia, Yasemin Cag, Ami Neuberger, Botond Lakatos, Serkan Oncu, Hasip Kahraman, Simin Aysel Florescu, Gorana Dragovac, Daniel Codreanu, Ilaria Coledan, Mirjana Strbac, Rodrigo Hasbun, Jelena Djekic Malbasa, Natalia Pshenichnaya, Olga Shmaylenko, Éva Nagy, Razi EvendarHakan Erdem, Galina Gopatsa, Natalia Pshenichnaya, Nenad Pandak, Selma Tosun, Emanoil Ceausu, Simona Maria Ruta, Hakan Erdem, Arjan Harxhi

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

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.
Original languageEnglish
Pages (from-to)104213-
Number of pages6
JournalJOURNAL OF CLINICAL VIROLOGY
Volume122
Publication statusPublished - 2020

All Science Journal Classification (ASJC) codes

  • Virology
  • Infectious Diseases

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