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. 2021 Aug;27(4):609-615.
doi: 10.1007/s13365-021-01003-w. Epub 2021 Aug 3.

Risk factors for neurological complications in children with Flavivirus infection

Aline Almeida Bentes  1   2 , Roberta Maia de Castro Romanelli  1 , Paula Eillanny Silva Marinho  3 , Ana Paula Correa Crispim  3 , Karina Soares Loutfi  2 , Eisler Cristiane Carvalho Viegas  2 , Erna Geessien Kroon  4
Affiliations

Risk factors for neurological complications in children with Flavivirus infection

Aline Almeida Bentes et al. J Neurovirol. 2021 Aug.

Abstract

This study aims to characterize the acute neurological manifestations caused by DENV, ZIKV, and YFV during hospitalization; identify the risk factors associated with persistent neurological complications after discharge; and evaluate the time to resolution during clinical follow-up. A prospective study evaluated 505 children, between March 2014 and July 2019, hospitalized with neurological manifestations and that doctors suspected infection of the central nervous system (CNS). Viral infection of collected cerebrospinal fluid (CSF) was confirmed by real-time reverse transcription-polymerase chain reaction (RT-PCR). Patients were clinically followed up after hospital discharge. Analysis of predictive factors and survival curves was performed. This study identified clinical symptoms and changes in the CSF laboratory, electroencephalogram (EEG), and CNS image as predictors of complications in children with confirmed infection in the CNS by DENV, ZIKV, or YFV. No statistical difference was found (p value 0.574) in the time to the resolution of complications in children after hospital discharge between the three types of flaviviruses. Children with YFV, detected in CSF samples, had a 53% higher risk of developing neurological complications. Performing etiological diagnosis by RT-PCR of CSF samples of children with neurological manifestations, especially during Flavivirus outbreaks, is an essential tool for improving the prognosis and clinical follow-up of these patients.

Keywords: Dengue virus; Encephalitis; Flavivirus; Meningitis; Myelitis; Neurological complication; Risk factors; Yellow fever virus; Zika virus.

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References

    1. Abdulwahab AH, Omima GM, Hayat SEK, Khalid AOK, Waled AA (2015) Epidemiological, clinical and entomological characteristics of yellow fever outbreak in Darfur 2012. AIMS Public Heal 2(1):132–141. https://doi.org/10.3934/publichealth.2015.1.132 - DOI
    1. American Academy of Sleep Medicine (2014) ICSD—International Classification of Sleep Disorders, revised: Diagnostic and coding manual. American Academy of Sleep Medicine
    1. Beckham JD, Tyler KL (2015) Arbovirus infections. Contin Lifelong Learn Neurol 1599–1611. https://doi.org/10.1212/CON.0000000000000240
    1. Bentes A, Kroon EG, Romanelli RM de Castro (2019) Neurological manifestations of pediatric arboviral infections in the Americas. J Clin Virol 116:49–57. https://doi.org/10.1016/j.jcv.2019.04.006
    1. Cam BV, Fonsmark L, Hue NB, Phuong NT, Poulsen A, Heegaard ED (2001) Prospective case-control study of encephalopathy in children with dengue hemorrhagic fever. Am J Trop Med Hyg 65(6):848–851. https://doi.org/10.4269/ajtmh.2001.65.848 - DOI - PubMed

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