Aspectos clínicos e epidemiológicos de pacientes internados por Varicela ou Herpes Zoster em um hospital público de referência para doenças infecciosas em Fortaleza-CE, 2009- 2018

Abstract

Chickenpox and herpes zoster (HZ) are pathologies caused by the same etiological agent: the varicella zoster virus (VZV). The aim of this study is to relate sociodemographic, epidemiological and clinical conditions to the occurrence of severe cases of chickenpox and herpes zoster diagnosed in patients admitted to the São José Hospital for Infectious Diseases (SJH) in the city of Fortaleza - Ceará, from 2009 to 2018 through an analytical cross-sectional study. All selected variables were analyzed using the Stata version 15.1 program. The project was approved by the HSJ ethics committee. 302 medical records of patients with chickenpox were analyzed, most of them male (54.3%); with a median age of 8 years; students (43.2%), with basic education level (33.2%) and coming from regional V (25.8%). Household contact with the virus occurred in 25.6%. Risk factors to worsen the condition were observed in 21.3%, however, the presence of complications occurred in 82.4%. Cutaneous complications occur in (65.4%), and 2.3% of hospitalizations died. In the bivariate analysis, changes in the chest X-ray result and use of antiviral and antibiotic showed significant prevalence with the severity of the cases (p <0.05). For patients hospitalized for herpes zoster, the highest frequency was male (52.0%); with a median age of 43 years; active in the labor market (27.5%), with basic education level (39.0%) and coming from regional V (24.0%). Risk factors were observed in 57.7% and the presence of complications occurred in 69.9%, with cutaneous complications being the most frequent (50.0%). The most affected region was the cranial (68.9%), and 1.5% died. In the bivariate analysis, cutaneous lesions in the gallbladder phase and use of antiviral and antibiotic had a significant prevalence with the severity of the cases (p <0.05). Both chickenpox and herpes zoster continue to substantially affect the most vulnerable population, some measures have already been taken, others such as vaccination against zoster should be performed to significantly reduce cases. Chickenpox and herpes zoster showed that they should not be underestimated due to the number of complications observed, even in immunocompetent individuals, leading to hospitalization and in some cases the need for intensive care. The disease can be more serious depending on the clinical form of the lesions, changes in the chest x-ray and the therapeutic approach.