Correlation of clinical illness with viremia in Zika virus disease during an outbreak in Singapore
Correlation of clinical illness with viremia in Zika virus disease during an outbreak in Singapore
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DOI：
10.1186/s12879-018-3211-9
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发表时间：
2018-07-04
影响因子：
3.7
通讯作者：
Leo, Yee Sin
中科院分区：
文献类型：
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作者：
Ng, Deborah H. L.;Ho, Hanley J.;Leo, Yee Sin
背景：新加坡于2016年8月发现首例本土寨卡病毒(ZIKV)疫情。我们报告了这一亚洲队列中临床疾病与病毒血症和实验室参数的相关性分析。方法：我们对新加坡陈德胜医院接受隔离和治疗的血液ZIKV聚合酶链式反应(PCR)阳性患者进行了前瞻性纵向队列研究。所有患者均有皮疹，其中80%(32/40)有发热，62.5%(25/40)有肌痛，60%(24/40)有结膜炎，38%(15/40)有关节痛。病毒血症的中位持续时间为3.5d(IQR：3~5d)。病毒血症天数的患者比病毒血症<4天的患者更有可能出现持续发热(95%比63%，P=0.01)，但与其他临床症状和实验室检查无明显相关性。然而，21例(53%)患者在没有胃肠道症状的情况下仍有低钾血症。结论：虽然发热与病毒血症的持续时间有关，但30%的患者尽管退热仍保持病毒血症。实验室异常，如白细胞减少或血小板减少，在这个队列中并不明显，但约有一半的患者被注意到有低钾血症。
Background: The first autochthonous Zika virus (ZIKV) outbreak in Singapore was detected in August 2016. We report an analysis of the correlation of clinical illness with viremia and laboratory parameters in this Asian cohort.Methods: We conducted a prospective longitudinal cohort study of patients with a positive blood ZIKV polymerase chain reaction (PCR) result who were admitted to Tan Tock Seng Hospital, Singapore, for isolation and management.Results: We included 40 patients in our study. Rash was present in all patients, while 80% (32/40) had fever, 62.5% (25/40) myalgia, 60% (24/40) conjunctivitis and 38% (15/40) arthralgia. The median duration of viremia was 3.5 days (IQR: 3-5 days). Patients with viremia of days were more likely to have prolonged fever compared to those with viremia of less than >= 4 days (95% versus 63%, p = 0.01), but had no significant correlation with other clinical signs and symptoms, or laboratory investigations. However, 21 patients (53%) had hypokalemia despite the absence of gastrointestinal symptoms.Conclusion: Although fever correlated with duration of viremia, 30% of patients remained viremic despite defervescence. Laboratory abnormalities such as leukopenia or thrombocytopenia were not prominent in this cohort but about half the patients were noted to have hypokalemia.