ArticlePLoS neglected tropical diseases2019
Risk factors for hospitalization of patients with chikungunya virus infection at sentinel hospitals in Puerto Rico.
Article in PLoS neglected tropical diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.
- Events preceding death among chikungunya virus infected patients: a systematic review.Revista da Sociedade Brasileira de Medicina Tropical · 2020Pooled it
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- Respiratory Transmission Potential of Chikungunya Virus: Integrating Aerosol Stability, Clinical Evidence, and Mechanistic Insights.Microorganisms · 2026Review
- Clinical characteristics and mortality of critically ill patients with chikungunya infection: a multicenter study in Paraguay.BMC infectious diseases · 2026Observational
- Immune features and clinical characteristics of chikungunya fever in children: differences from adults and across pediatric age groups.Frontiers in pediatrics · 2026Review
- Epidemiology of Chikungunya Hospitalizations, Brazil, 2014-2024.Emerging infectious diseases · 2025Article
- Sentinel Enhanced Dengue Surveillance System - Puerto Rico, 2012-2022.Morbidity and mortality weekly report. Surveillance summaries (Washington, D.C. : 2002) · 2024Article
- The Chikungunya anxiety scale (CHIKAS): Development, validation, and relationship between its items and illness-related factors.Industrial psychiatry journal · 2023Article
- Immune Response to Chikungunya Virus: Sex as a Biological Variable and Implications for Natural Delivery via the Mosquito.Viruses · 2023Review
- MAVS signaling is required for preventing persistent chikungunya heart infection and chronic vascular tissue inflammation.Nature communications · 2023Article
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- Article
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- Review
- The global burden of Chikungunya fever among children: A systematic literature review and meta-analysis.PLOS global public health · 2022Article
- Clinical Characteristics, Histopathology, and Tissue Immunolocalization of Chikungunya Virus Antigen in Fatal Cases.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Rediscovering the chikungunya virusBiomedica : revista del Instituto Nacional de Salud · 2021Review
- Etiologies of severe acute respiratory infection (SARI) and misdiagnosis of influenza in Indonesia, 2013-2016.Influenza and other respiratory viruses · 2021Article
- Neurological disease in adults with Zika and chikungunya virus infection in Northeast Brazil: a prospective observational study.The Lancet. Neurology · 2020Observational
- Estimated mortality rate and leading causes of death among individuals with chikungunya in 2016 and 2017 in Brazil.Revista da Sociedade Brasileira de Medicina Tropical · 2020Observational
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Authors and funding
14 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHospitalization of patients during outbreaks of chikungunya virus has been reported to be uncommon (0.5-8.7%), but more frequent among infants and the elderly. CHIKV was first detected in Puerto Rico in May 2014. We enrolled patients with acute febrile illness (AFI) presenting to two hospital emergency departments in Puerto Rico and tested them for CHIKV infection to describe the frequency of detection of CHIKV-infected patients, identify risk factors for hospitalization, and describe patients with severe manifestations. METHODOLOGY/PRINCIPAL
findingsSerum specimens were collected from patients with AFI and tested by rRT-PCR. During May-December 2014, a total of 3,035 patients were enrolled, and 1,469 (48.4%) had CHIKV infection. A total of 157 (10.7%) CHIKV-infected patients were hospitalized, six (0.4%) were admitted to the intensive care unit, and two died (0.1%). Common symptoms among all CHIKV-infected patients were arthralgia (82.6%), lethargy (80.6%), and myalgia (80.5%). Compared to patients aged 1-69 years (7.3%), infant (67.2%) and elderly (17.3%) patients were nine and two times more likely to be hospitalized, respectively (relative risk [RR] and 95% confidence interval [CI] = 9.16 [7.05-11.90] and 2.36 [1.54-3.62]). Multiple symptoms of AFI were associated with decreased risk of hospitalization, including arthralgia (RR = 0.31 [0.23-0.41]) and myalgia (RR = 0.29 [0.22-0.39]). Respiratory symptoms were associated with increased risk of hospitalization, including rhinorrhea (RR = 1.68 [1.24-2.27) and cough (RR = 1.77 [1.31-2.39]). Manifestations present among <5% of patients but associated with patient hospitalization included cyanosis (RR = 2.20 [1.17-4.12) and seizures (RR = 3.23 [1.80-5.81). DISCUSSION: Among this cohort of CHIKV-infected patients, hospitalization was uncommon, admission to the ICU was infrequent, and death was rare. Risk of hospitalization was higher in patients with symptoms of respiratory illness and other manifestations that may not have been the result of CHIKV infection.
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