Formas atípicas de chikungunya em pacientes internados durante a epidemia na cidade de Fortaleza, Ceará, 2017

Abstract

Ceará experienced two epidemic waves of infection by the chikungunya virus in the years 2016 and 2017, recording incidence rates of 365.5 and 1,174.9 per 100,000 inhabitants, respectively. This justifies its high attack rate in a population without previous contact with the virus. The disease is usually mild, with some cases progressing to atypical / severe cases and deaths. During the epidemic, an increase in hospitalizations of patients with CHIKV who had complications in other organs and / or systems was reported by health care physicians. The aim of the study was to investigate confirmed cases of chikungunya that evolved with atypical and / or severe manifestations of the disease, admitted to public and private hospitals in Fortaleza, during the epidemic in Ceará, in 2017. This is a cross-sectional study descriptive, with secondary data. The sample consisted of 148 records collected using a data collection instrument in six hospitals located in the city of Fortaleza. The hospitalized cases and deaths fell ill between the months of April and May, 45.9% were 60 years old or older (interval 5 days -106 years), the most prevalent sex was male with 52.7%, the most frequent occupation was retired with 50.0%. The most common symptoms were fever, (93.9%), followed by arthralgia with (62.9%) and myalgia with (29.7%). Hospital X had the highest number of hospitalizations, (37.1%). They had (57.4%) comorbidity, (71,8%) of whom were elderly. The most cited pre-existing diseases were systemic hypertension with (61.2%) and diabetes mellituswith (41.2%). The atypical manifestations found were: neurological (66.9%), with irritability and drowsiness more present in the elderly, respiratory (52,0%), with respiratory failure in all age groups, dermatological (37,8%), with bullous desquamation in children younger than one year, renal (16,9%), with renal failure present mostly in the elderly and cardiovascular manifestations 11,5%), with arrhythmia and heart failure. The municipalities with the most residents present in the study were Fortaleza and Caucaia with (66.9%) and (6.7%), respectively. The most used medications before hospitalization were anti-inflammatory drugs, (33.1%), followed by antipyretics / analgesics, (22.4%). During hospitalization, analgesics were the drugs of choice with (88.5%) followed by antibiotics (66.2%), antihypertensive drugs (35.8%) and corticosteroids (32.4%).There was a high number of cases with atypical manifestations admitted during the 2017 epidemic, with a high mortality rate.