美国西尼罗河神经侵入性疾病和死亡率的危险因素,2013-2024年
1Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles.
JAMA network open
|December 10, 2025
概括
西尼罗病毒 (WNV) 感染可能导致严重的神经侵入性疾病 (WNND). 伴随性疾病如CKD和CEVD,以及年龄较大和男性性别,增加了WNND风险和死亡率.
科学领域:
- 流行病学 流行病学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 西尼罗河病毒 (WNV) 是美国蚊子传播的重要病原体,导致西尼罗河热和潜在的严重西尼罗河神经侵入性疾病 (WNND).
- 了解WNND和相关死亡率的风险因素对于有效的公共卫生干预和资源分配至关重要.
研究的目的:
- 确定与WNND发展相关的人口和并发症相关的风险因素.
- 评估WNND对成年感染者全因死亡率的影响.
- 为高风险人群制定有针对性的预防策略.
主要方法:
- 使用TriNetX研究网络 (2013年1月至2024年12月) 匿名电子病历数据进行的回顾性队列研究.
- 包括65个美国医疗机构诊断出WNV感染的患者.
- 对人口特征,并发病症和药物使用作为WNND和死亡率的潜在风险因素的分析.
主要成果:
- 该研究分析了3064名患有WNV感染的患者,确定了1127例WNND.
- WNND的主要风险因素包括年龄,男性性别,慢性病 (CKD),脑血管疾病 (CEVD),血液性恶性瘤,免疫抑制剂使用,高血压,与酒精有关的疾病和多发性硬化症.
- WNND是30天死亡率的重要风险因素,死亡率增加也与老年,CKD和CEVD有关.
结论:
- 多重并发症是发展WNND的重要风险因素.
- 患有WNND的患者面临着大幅增加的死亡风险.
- 针对具有已识别风险因素的个体的有针对性的预防和干预策略对于减轻与WNV相关的发病率和死亡率至关重要.
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