Risk factors for death among patients with Chikungunya virus infection during the outbreak in northeast Brazil, 2016–2017

Abstract

Chikungunya virus (CHIKV) infection is a current public health problem. The aim of this study was to investigate risk factors for death among patients with CHIKV infection during a large epidemic in northeast Brazil. This is a cross-sectional study with all registered cases of CHIKV in Ceara, Brazil, during 2016–2017. Data from notification reports were collected, and we have compared non-survivors and survivors. A total of 182 731 cases were reported, with a mean age of 38±19 years, and the majority was female (62%). There were 383 deaths. Non-survivors were elderly, with a predominance of males, and with a lower educational level. Conditions that were significantly more frequent in the non-survivor group were systemic arterial hypertension, diabetes mellitus and chronic kidney disease (p<0.0001). Independent risk factors for death were advanced age (OR 7.35, p<0.0001), male gender (OR 2.05, p<0.0001), leukopenia (OR 3.18, p<0.0001) and vomiting (OR 2.19, p<0.0001), and comorbidities like hypertension (OR 3.74, p<0.0001), diabetes (OR 3.29, p<0.0001) and chronic kidney disease (OR 3.14, p<0.0001). Advanced age and low educational level were associated with higher risk of mortality in CHIKV. Leukopenia and vomiting were signs of severity, as well as the presence of comorbidities, especially hypertension, diabetes and kidney disease.