A meta-analysis of Chikungunya virus in neurological disorders

Author(s)

da Costa, Vivaldo G. ; Saivish, Marielena V. ; Sinhorini, Paola F. ; Nogueira, Mauricio L. ; Rahal, Paula

• Document type: Journal article
• Source: INFECTIOUS DISEASES NOW; v. 54, n. 5, p. 8-pg., 2024-06-25.

Abstract

Chikungunya disease typically presents with the fever-arthralgia-rash symptom triad. However, an increase in the number of atypical clinical manifestations, particularly neurological disorders, has occurred. The current evidence regarding the pooled prevalence of Chikungunya virus (CHIKV)-associated neurological cases (CANCs) suspected of having an arboviral aetiology is not well-understood. Therefore, this meta-analysis included 19 studies (n = 7319 patients) and aimed to determine the pooled rate of exposure to CANC. The pooled positivity rate of CANC was 12 % (95 % CI: 6-19), and Brazil was overrepresented (11/19). These estimations varied between 3 and 14 % based on the diagnostic method (real-time PCR vs. ELISA-IgM) and biological samples (cerebrospinal fluid or blood specimens) used for detection of CHIKV. Regarding the frequency of CHIKV in neurological clinical subgroups, the rates were higher among patients with myelitis (27 %), acute disseminated encephalomyelitis (27 %), Guillain-Barre<acute accent> syndrome (15 %), encephalitis (12 %), and meningoencephalitis (7 %). Our analysis highlights the significant burden of CANC. However, the data must be interpreted with caution due to the heterogeneity of the results, which may be related to the location of the studies covering endemic periods and/or outbreaks of CHIKV. Current surveillance resources should also focus on better characterizing the epidemiology of CHIKV infection in neurological disorders. Additionally, future studies should investigate the interactions between CHIKV and neurological diseases with the aim of gaining deeper insight into the mechanisms underlying the cause-and-effect relationship between these two phenomena. (AU)

• FAPESP's process: 23/09590-7 - Development of a diagnostic method for the rocio virus and the use of new compounds as inhibitors of the flavivirus NS2B-NS3 protease-helicase
• Grantee: Marielena Vogel Saivish
• Support Opportunities: Scholarships abroad - Research Internship - Doctorate
• FAPESP's process: 20/12875-5 - Development of the diagnostic method for Rocio virus and use of new compounds as inhibitors of flavivirus protease-helicase NS2B-NS3
• Grantee: Marielena Vogel Saivish
• Support Opportunities: Scholarships in Brazil - Doctorate
• FAPESP's process: 23/10809-3 - Application of metagenomics for studies of viral diversity in bats and analysis of the inhibitory activity of peptides against viral isolates
• Grantee: Vivaldo Gomes da Costa
• Support Opportunities: Scholarships in Brazil - Support Program for Fixating Young Doctors
• FAPESP's process: 22/03645-1 - Study of the virus-vector interaction and the mechanisms involved in modulating the dynamics of viral transmission
• Grantee: Maurício Lacerda Nogueira
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 23/01598-9 - Application of metagenomics for studies of viral diversity in bats and analysis of the inhibitory activity of peptides against viral isolates
• Grantee: Paula Rahal
• Support Opportunities: Regular Research Grants
• FAPESP's process: 20/08615-8 - Protein exosites, cryptic sites and moonlighting: identification, functional mapping and effects of changes in structure
• Grantee: Raghuvir Krishnaswamy Arni
• Support Opportunities: Research Projects - Thematic Grants