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Long-term Sequelae Associated With Severe West Nile Virus Disease in Maricopa County, Arizona, 2021
Anna C Fagre1,2, Kathryn G Burr1,3,4, Cedar L Mitchell1,4,5
1Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Background:
West Nile virus (WNV)-specific long-term sequelae (LTS) are not well-defined. We assessed LTS in patients hospitalized with WNV disease and compared their outcomes to an age- and sex-matched cohort of patients hospitalized with other infectious diseases.
Methods:
A total of 159 patients with WNV disease and 75 patients with predominantly COVID-19 and coccidioidomycosis completed standardized assessment tools (modified Rankin Scale, modified Control and Prevention Symptom Inventory Checklist, and 36-Item Short Form Survey) 17-24 months after hospitalization.
Results:
Among patients with WNV, 40% were transferred to long-term care facilities, and 83% experienced ongoing symptoms, including fatigue, myalgia, arthralgia, pain, and problems with sleep, memory, and concentration. Overall, 33% reported disabilities and 55% reported worse health than before illness. The hospitalized infectious disease comparators reported similar LTS but had worse adjusted physical composite scores and a higher proportion reporting poor or fair health.
Conclusions:
Long-term sequelae in patients hospitalized with WNV were common up to 2 years after hospitalization, but similar findings to comparators suggest there might be common inflammatory or other physiologic pathways leading to post infectious sequelae or outcomes related to hospitalization. Providers caring for patients hospitalized with WNV should make patients and caregivers aware of the prolonged and possible incomplete recovery process.
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