Características epidemiológicas, clínicas e abordagem terapêutica de pacientes com febre chikungunya atendidos no IMIP: dados de uma coorte.

Abstract

Background: Chikungunya fever is considered a global health problem because of its morbidity and socioeconomic losses as there is no specific antiviral treatment. It became epidemic in Brazil, between 2014 and 2015, being Pernambuco one of the most affected cities. This study aimed to analyze the clinical manifestations, the epidemiologic factors and treatment prescribed in IMIP. Methods: This study had longitudinal and transversal designs, carried out at the Instituto Materno Infantil de Pernambuco - IMIP, from August 2017 to July 2018, involving 78 patients. Data collection was done by clinical evaluation and review of medical records data. The analyzes were made using graphpad prism software V. 6.0. Results: Our study population consisted of 66 women (84.62%) and 12 men (15.38%), with a mean age of 50.42 years. Eighteen patients (23.07%) had previous rheumatologic disease (PRD) and compared to patients with no PRD there was an association with previous use of NSAIDs (p = 0.023). In the subacute phase, there was significant difference in visual analogue scale for fatigue and for disease global evaluation by the physician, p = 0.009 and p = 0.03, respectively for elderly and non-elderly patients. When compared the acute/subacute phases with chronic phase of the disease, there was a significant reduction in the number of painful (p <0.0001) and swollen joints (p = 0.002). Regarding the clinical management, we analyzed that the use of hydroxychloroquine in corticoids was associated with an improvement in a greater number of clinical parameters when comparing the acute/subacute with chronic phases. Conclusion: A presentation evaluated in the study demonstrated clinical characteristics similar to other cohorts. There were no differences in clinical manifestations in with or without PRD. Treatment with hydroxychloroquine and corticosteroids was associated with an improvement in clinical parameters when compared with the acute and chronic phases. However, additional studies with larger numbers of patients are needed.