Aspectos clínicos, laboratoriais e histopatológicos dos óbitos por Chikungunya, necropsiados no Ceará, 2016 - 2017

Abstract

Chikungunya virus infection (CHIKV) is characterized as a debilitating disease associated with inflammation and chronic joint pain, which has increasingly been associated with unfavorable outcomes. In these cases, necropsy becomes an important tool to elucidate the causes of these deaths. Objective: To describe the main clinical, laboratory and histopathological findings of CHIKV confirmed necropsied deaths in Ceará during the 2016 and 2017 epidemics. Methods: a descriptive study was carried out involving patients with Chikungunya (CHIK) who were necropsied by the Death Registry Service dr. Rocha Furtado (SVO-RF). The epi-info version 7.2.2 software was used for analysis. Results: 75 laboratory-confirmed deaths by CHIK were included in the study. The predominance was female (52%) and the age group was between 51 and 60 years old. The most frequent sign was fever (77,6%) and the main comorbidity was hypertension (47,6%). The organ that presented the most changes in macro and microscopy was the lung. Bleeding was not very prevalent. Among the studied cavity effusions, pleural effusion was the most prevalent (48,7%). In microscopy, all organs presented congestion and edema. Encephalitis (21,9%) and haemorrhage (19,1%) were more frequently found in the histology of the nervous tissue. In the liver were more prevalent: inflammatory infiltrate (68,1%) and cholestasis (59,7%). Hypertrophy of cardiac cells (74,3%) and myocarditis (37,8%) were cardiac alterations found. In the kidneys the prevalence of tubular necrosis was 51.2%, followed by inflammatory infiltrate (49,3%). The immediate causes of deaths in death certificates were respiratory failure (38,7%) and septic shock (9,3%). Conclusion: Because it is a relatively new disease on the national scene, the description of the deaths and necropsy may help to identify possible cases and to understand the pathogenesis of chikungunya.