Volume 22, Number 5—May 2016
Dispatch
Severe Sepsis and Septic Shock Associated with Chikungunya Virus Infection, Guadeloupe, 2014
Amélie Rollé, Kinda Schepers, Sylvie Cassadou, Elodie Curlier, Benjamin Madeux, Cécile Hermann-Storck, Isabelle Fabre, Isabelle Lamaury, Benoit Tressières, Guillaume Thiery, and Bruno Hoen
Table 2
Selected characteristics of 110 nonpregnant adult patients with chikungunya virus infection, by presence or absence of sepsis or septic shock, University Hospital of Pointe-à-Pitre, Guadeloupe, French West Indies, January–November 2014*
| Characteristic | Severe sepsis or septic shock, n = 25 | No severe sepsis or septic shock, n = 85 | p value† |
|---|---|---|---|
| Baseline characteristics | |||
| Median age, y (interquartile range) | 70 (59–77) | 70 (59–78) | 0.966 |
| Male sex | 17 (68) | 45 (53) | 0.252 |
| Preexisting comorbid conditions | |||
| Immune suppression | 1 (4) | 4 (5) | 1 |
| Diabetes mellitus | 10 (40) | 34 (40) | 1 |
| Chronic heart disease | 6 (26) | 14 (17) | 0.374 |
| Cerebrovascular disease | 1 (4) | 6 (8) | 1 |
| Chronic lung disease | 2 (9) | 1 (1) | 0.124 |
| Chronic liver disease | 1 (4) | 0 (0) | 0.223 |
| Chronic renal disease | 3 (13) | 6 (8) | 0.414 |
| Cancer | 1 (4) | 6 (7) | 1 |
| Charlson index, median (interquartile range) | 4 (3–5) | 4 (2–5) | 0.579 |
| McCabe class 1 |
9 (39) |
21 (26) |
0.296 |
| Clinical symptoms, present on admission to hospital | |||
| Arthralgia/arthritis | 19 (91) | 60 (80) | 0.347 |
| Headache | 3 (17) | 21 (30) | 0.376 |
| Fever | 21 (84) | 75 (90) | 0.467 |
| Myalgia | 8 (44) | 29 (45) | 1 |
| Cardiac manifestations | 20 (80) | 18 (22) | <0.001 |
| Central nervous system manifestations | 8 (32) | 25 (30) | 1 |
| Respiratory manifestations | 18 (72) | 20 (24) | <0.001 |
| Hepatic manifestations | 7 (28) | 6 (8) | 0.012 |
| Renal manifestations |
17 (71) |
15 (19) |
<0.001 |
| Organ failures, at any time of the course of the disease | |||
| Cardio-circulatory failure | 17 (68) | 5 (6) | <0.001 |
| Neurologic failure | 3 (12) | 3 (4) | 0.129 |
| Respiratory failure | 14 (56) | 7 (8) | <0.001 |
| Liver failure | 6 (24) | 3 (4) | 0.004 |
| Renal failure |
13 (52) |
2 (2) |
<0.001 |
| Laboratory data, median (interquartile range) | |||
| Whole leukocytes, day 1, G/L | 8.10 (6.10–13.10) | 5.80 (4.10–7.10) | 0.004 |
| Whole leukocytes, days 2–7, G/L | 10.70 (3.40–15.00) | 3.05 (2.35–7.00) | <0.001 |
| Polymorphonuclear neutrophils, day 1, G/L | 5.96 (4.48–11.02) | 4.30 (2.82–5.91) | 0.01 |
| Polymorphonuclear neutrophils, days 2–7, G/L | 8.73 (2.55–12.02) | 1.80 (1.09–5.86) | <0.001 |
| Hemoglobin, day 1, g/dL | 12.1 (10.6–13.5) | 12.5 (11.2–13.5) | 0.796 |
| Hemoglobin, days 2–7, g/dL | 10.6 (7.9–11.7) | 11.7 (10.3–12.9) | 0.013 |
| Platelets, day 1, G/L | 139 (106–192) | 176 (123–233) | 0.063 |
| Platelets, days 2–7, G/L | 104 (59–189) | 149 (108–200) | 0.03 |
| C-reactive protein, day 1, mg/L | 46 (20–75) | 40 (20–79) | 0.856 |
| C-reactive protein, days 2–7, mg/L | 92 (41–204) | 70 (33–106) | 0.119 |
| Lactate dehydrogenase, day 1, IU/L | 606 (288–946) | 310 (226–401) | 0.007 |
| Lactate dehydrogenase, days 2–7, IU/L | 422 (346–1600) | 363 (266–422) | 0.05 |
| Creatine kinase, day 1, IU/L | 653 (304–1394) | 264 (140–639) | 0.08 |
| Creatine kinase, day 2, IU/L | 911 (357–3932) | 727 (163–2642) | 0.283 |
| Aspartate aminotransferase, day 1, IU/L | 60 (39–127) | 33 (24–48) | 0.001 |
| Aspartate aminotransferase, days 2–7, IU/L | 125 (36–626) | 54 (35–104) | 0.044 |
| Alanine aminotransferase, day 1, IU/L | 33 (24–57) | 20 (15–31) | 0.02 |
| Alanine aminotransferase, days 2–7, IU/L | 56 (28–499) | 30 (19–61) | 0.055 |
| Creatinine, day 1, µmol/L | 157 (114–343) | 96 (77–134) | 0.008 |
| Creatinine, days 2–7, µmol/L |
226 (123–570) |
101 (76–141) |
0.002 |
| Outcome | |||
| Death | 12 (48) | 2 (3) | <0.001 |
*Values are no. (%) except as indicated. All patients were hospitalized and had infection confirmed by reverse transcription PCR.
†p value denotes the comparisons between the 25 patients with severe sepsis or septic shock and the 85 patients with no severe sepsis or septic shock, based on nonparametrical tests.
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Page updated: April 13, 2016
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