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Volume 22, Number 5—May 2016
Dispatch

Severe Sepsis and Septic Shock Associated with Chikungunya Virus Infection, Guadeloupe, 2014

Amélie Rollé, Kinda Schepers, Sylvie Cassadou, Elodie Curlier, Benjamin Madeux, Cécile Hermann-Storck, Isabelle Fabre, Isabelle Lamaury, Benoit Tressières, Guillaume Thiery, and Bruno HoenComments to Author 
Author affiliations: Centre Hospitalier Universitaire, Pointe-à-Pitre, France (A. Rollé, K. Schepers, E. Curlier, B. Madeux, C. Hermann-Storck, I. Fabre, I. Lamaury, G. Thiery, B. Hoen); Cellule Interrégionale d’Epidémiologie Antilles-Guyane, Institut de Veille Sanitaire, Gourbeyre, France (S. Cassadou); Centre d’Investigation Clinique 1424, Institut National de la Santé et de la Recherche Médicale, Pointe-à-Pitre (B. Tressières, B. Hoen); Université des Antilles, Faculté de Médecine Hyacinthe Bastaraud, Pointe-à-Pitre (G. Thiery, B. Hoen)

Main Article

Table 1

Selected characteristics of 110 nonpregnant adult patients with chikungunya virus infection, by severity of disease, University Hospital of Pointe-à-Pitre, Guadeloupe, French West Indies, January–November 2014*

Characteristic
 Nonsevere, n = 68
 Severe, n = 42
 p value†
Baseline characteristics
Median age, y (interquartile range) 71 (59–80) 68 (58–77) 0.27
Male sex 36 (53) 26 (62) 0.36
Preexisting comorbid conditions
Immune suppression 4 (6) 1 (2) 0.69
Diabetes mellitus 28 (41) 16 (38) 0.75
Chronic heart disease 9 (14) 11 (28) 0.07
Cerebrovascular disease 6 (9) 1 (3) 0.35
Chronic lung disease 1 (2) 2 (5) 0.66
Chronic liver disease 0 1 (3) 0.8
Chronic renal disease 5 (8) 4 (10) 0.95
Cancer 5 (8) 2 (5) 0.92
Charlson index, median (interquartile range) 4 (3–5) 4 (1–5) 0,41
McCabe class 1
 50 (77)
 24 (62)
 0.09
Clinical symptoms, present on admission to hospital
Arthralgia/arthritis 49 (82) 30 (83) 0.84
Headache 21 (39) 3 (9) 0,002
Fever 61 (92) 35 (83) 0.25
Myalgia 24 (48) 13 (41) 0.41
Cardiac manifestations 10 (15) 28 (67) <0.001
Central nervous system manifestations 20 (30) 13 (31) <0.001
Respiratory manifestations 9 (14) 29 (71) <0.001
Hepatic manifestations 1 (2) 12 (29) <0.001
Renal manifestations
 12 (19)
 20 (50)
 0.001
Organ failures, at any time of the course of the disease
Cardio-circulatory failure 0 22 (52) <0.001
Neurologic failure 0 6 (14) 0.006
Respiratory failure 0 21 (50) <0.001
Liver failure 0 9 (21) <0.001
Renal failure
 0
 15 (36)
 <0.001
Laboratory data, median (interquartile range)
Whole leukocytes, day 1, G/L 5.80 (4.00–7.00) 7.50 (4.90–13.00) 0.01
Whole leukocytes, days 2–7, G/L 3.00 (2.10–5.40) 8.70 (3.20–14.70) <0.001
Polymorphonuclear neutrophils, day 1, G/L 4.16 (2.82–5.43) 5.59 (3.40–10.94) 0.01
Polymorphonuclear neutrophils, days 2–7, G/L 1.63 (1.05–5.02) 7.13 (2.32–11.82) <0.001
Hemoglobin, day 1, g/dL 12.6 (11.3–13.6) 12.1 (10.2–13.5) 0.25
Hemoglobin, days 2–7, g/dL 11.9 (11.3–13.6) 8.6 (10.5–11.6) <0.001
Platelets, day 1, G/L 178(125–233) 147 (107–199) 0.13
Platelets, days 2–7, G/L 160 (110–200) 108 (75–189) 0.04
C-reactive protein, day 1, mg/L 36 (20–79) 43 (16–75) 0.57
C-reactive protein, days 2–7, mg/L 70 (33–106) 94 (37–167) 0.24
Lactate dehydrogenase, day 1, IU/L 286 (207–354) 579 (310–1135) 0.001
Lactate dehydrogenase, days 2–7, IU/L 363 (248–418) 422 (335–1600) 0.04
Creatine kinase, day 1, IU/L 268 (132–808) 395 (237–740) 0.36
Creatine kinase, day 2, IU/L 973 (163–2826) 683 (240–2164) 0.85
Aspartate aminotransferase, day 1, IU/L 34 (25–48) 50 (30–127) 0.01
Aspartate aminotransferase, days 2–7, IU/L 28 (19–58) 64 (33–351) 0.2
Alanine aminotransferase, day 1, IU/L 20 (15–30) 31 (21–57) 0.02
Alanine aminotransferase, days 2–7, IU/L 28 (19–58) 40 (20–234) 0.1
Creatinine, day 1, µmol/L 95 (78–131) 119 (81–182) 0.07
Creatinine, days 2–7, µmol/L
 101 (81–139)
 153 (75–410)
 0.09
Outcome
Death 1 (2) 13 (31) <0.001

*Values are no. (%) except as indicated. All patients were hospitalized and had infection confirmed by reverse transcription PCR.
†p value denotes the comparisons between the 42 patients with severe forms and the 68 patients with nonsevere forms, based on nonparametrical tests.

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Page created: April 13, 2016
Page updated: April 13, 2016
Page reviewed: April 13, 2016
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