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Case Reports
. 2019 Jan-Dec:25:1076029618821184.
doi: 10.1177/1076029618821184.

Zika and Chikungunya Virus and Risk for Venous Thromboembolism

Eduardo Ramacciotti  1 , Leandro B Agati  1 , Valéria C R Aguiar  1 , Nelson Wolosker  2 , João C Guerra  2 , Roque P de Almeida  3 , Juliana Cardoso Alves  3 , Renato D Lopes  4 , Thomas W Wakefield  5 , Anthony J Comerota  6 , Jeanine Walenga  7 , Jawed Fareed  7
Affiliations
Case Reports

Zika and Chikungunya Virus and Risk for Venous Thromboembolism

Eduardo Ramacciotti et al. Clin Appl Thromb Hemost. 2019 Jan-Dec.

Abstract

A variety of viral infections are associated with hypercoagulable states and may be linked to the development of deep venous thrombosis and pulmonary embolism. The Zika and Chikungunya viral infections spread through the South and Central American continents, moving to North America in 2016, with severe cases of polyarthralgia, fever, and Guillain-Barré syndrome leading eventually to death. A decreased trend for both infections was reported in the first quarter of 2017. In this article, we report the possible association of venous thromboembolic events associated with Zika infection. After 2 cases of deep venous thrombosis in patients with acute Zika infections, D-dimer levels were measured in 172 consecutive patients who presented to the emergency department of a university hospital in an endemic region of Brazil with either Zika or Chikungunya infections confirmed by polymerase chain reaction tests. D-dimer levels were increased in 19.4% of 31 patients with Zika and in 63.8% of 141 patients with Chikungunya infections. The mechanisms behind this association are yet to be elucidated as well as the potential for venous thromboembolism prevention strategies for in-hospital patients affected by Zika and Chikungunya infections.

Keywords: Chikungunya virus; Zika virus; deep venous thrombosis.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
A 46-year-old female with Zika infection and upper limb deep venous thrombosis.
Figure 2.
Figure 2.
A 53-year-old Caucasian male with Zika infection and left lower limb deep venous thrombosis.
Figure 3.
Figure 3.
Comparative Zika and Chikungunya D-dimer levels.
Figure 4.
Figure 4.
Raw data regarding D-dimer levels from both groups (Zika and Chik) and age distribution.
See this image and copyright information in PMC

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