Clinical outcomes of hospitalized patients with chikungunya fever: A retrospective analysis

Objective:To describe the prognostic and clinical profile of hospitalized patients with chikungunya virus(CHIKV)infection focusing on renal outcomes.Methods:This is a cross-sectional study including all patients with confirmed chikungunya fever(CHIKF)admitted to 3 different highcomplexity hospitals in Fortaleza,Brazil between January 2016 and June 2017.Data analysis was carried out to evaluate correlation between clinical profile and outcomes.Results:Fifty-five patients were included,with a median age of 77(IQR=21)years,and 23(41.82%)were male.Twenty-five patients(45.45%,25/55)developed acute kidney injury(AKI),and 15(60.00%,15/25)were classified as KDIGO 1,1(4.00%)as KDIGO 2,and 9(36.00%)as KDIGO 3.The overall mortality was 34.54%whilst AKI-related mortality was 64.00%(16/25).Both AKI and encephalitis were associated with higher mortality.Patients who died were significantly older[82(IQR=12)years vs.70(IQR=28.75)years,P<0.001].In the multivariate analysis,abdominal pain was associated with an increased risk of severe AKI(OR=5.33,95%CI=1.11–25.64,P=0.037)and AKI was an independent risk factor of death(OR=12.06,95%CI=2.55–57.15,P=0.002).Recovery of renal function was similar among the different age groups.Conclusions:AKI is present in half of the study population and is an independent risk factor of death.Thus,renal function should be carefully monitored in hospitalized patients with CHIKV infection.