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1. Prevalence of chronic comorbidities in dengue fever and West Nile virus: A systematic review and meta-analysis.

Author

Alaa Badawi, Russanthy Velummailum, Seung Gwan Ryoo, Arrani Senthinathan, Sahar Yaghoubi, Denitsa Vasileva, Emma Ostermeier, Mikayla Plishka, Marcel Soosaipillai, and Paul Arora

Subjects
Medicine, Science
Abstract

BACKGROUND:Flavivirus diseases such as dengue fever (DENV), West Nile virus (WNV), Zika and yellow fever represent a substantial global public health concern. Preexisting chronic conditions such as cardiovascular diseases, diabetes, obesity, and asthma were thought to predict risk of progression to severe infections. OBJECTIVE:We aimed to quantify the frequency of chronic comorbidities in flavivirus diseases to provide an estimate for their prevalence in severe and non-severe infections and examine whether chronic diseases contribute to the increased risk of severe viral expression. METHODS:We conducted a comprehensive search in PubMed, Ovid MEDLINE(R), Embase and Embase Classic and grey literature databases to identify studies reporting prevalence estimates of comorbidities in flavivirus diseases. Study quality was assessed with the risk of bias tool. Age-adjusted odds ratios (ORs) were estimated for severe infection in the presence of chronic comorbidities. RESULTS:We identified 65 studies as eligible for inclusion for DENV (47 studies) and WNV (18 studies). Obesity and overweight (i.e., BMI> 25 kg/m2, prevalence: 24.5%, 95% CI: 18.6-31.6%), hypertension (17.1%, 13.3-21.8%) and diabetes (13.3%, 9.3-18.8%) were the most prevalent comorbidities in DENV. However, hypertension (45.0%, 39.1-51.0%), diabetes (24.7%, 20.2-29.8%) and heart diseases (25.6%, 19.5-32.7%) were the most prevalent in WNV. ORs of severe flavivirus diseases were about 2 to 4 in infected patients with comorbidities such as diabetes, hypertension and heart diseases. The small number of studies in JEV, YFV and Zika did not permit estimating the prevalence of comorbidities in these infections. CONCLUSION:Higher prevalence of chronic comorbidities was found in severe cases of flavivirus diseases compared to non-severe cases. Findings of the present study may guide public health practitioners and clinicians to evaluate infection severity based on the presence of comorbidity, a critical public health measure that may avert severe disease outcome given the current dearth of clear prevention practices for some flavivirus diseases.

Published
2018
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2. Prevalence of chronic comorbidities in dengue fever and West Nile virus: A systematic review and meta-analysis

Author

Denitsa Vasileva, Russanthy Velummailum, Seung Gwan Ryoo, Paul Arora, Alaa Badawi, Arrani Senthinathan, Emma Ostermeier, Marcel Soosaipillai, Mikayla Plishka, and Sahar Yaghoubi

Subjects
RNA viruses, Viral Diseases, Pulmonology, Physiology, viruses, lcsh:Medicine, Blood Pressure, Comorbidity, Dengue virus, Cardiovascular Medicine, medicine.disease_cause, Vascular Medicine, Dengue fever, Dengue Fever, Dengue, 0302 clinical medicine, Endocrinology, Mathematical and Statistical Techniques, Prevalence, Medicine, 030212 general & internal medicine, lcsh:Science, Pathology and laboratory medicine, Multidisciplinary, biology, virus diseases, Medical microbiology, Flavivirus, Infectious Diseases, Physiological Parameters, Cardiovascular Diseases, Viruses, Hypertension, Physical Sciences, Pathogens, West Nile virus, Statistics (Mathematics), Research Article, Neglected Tropical Diseases, medicine.medical_specialty, Endocrine Disorders, 030231 tropical medicine, Research and Analysis Methods, Microbiology, 03 medical and health sciences, Internal medicine, Diabetes mellitus, Diabetes Mellitus, Humans, Obesity, Statistical Methods, Medicine and health sciences, Biology and life sciences, Flaviviruses, business.industry, Public health, lcsh:R, Body Weight, Organisms, Viral pathogens, Odds ratio, medicine.disease, biology.organism_classification, Tropical Diseases, Microbial pathogens, Metabolic Disorders, Chronic Disease, Respiratory Infections, lcsh:Q, business, West Nile Fever, Mathematics, Meta-Analysis
Abstract

Background Flavivirus diseases such as dengue fever (DENV), West Nile virus (WNV), Zika and yellow fever represent a substantial global public health concern. Preexisting chronic conditions such as cardiovascular diseases, diabetes, obesity, and asthma were thought to predict risk of progression to severe infections. Objective We aimed to quantify the frequency of chronic comorbidities in flavivirus diseases to provide an estimate for their prevalence in severe and non-severe infections and examine whether chronic diseases contribute to the increased risk of severe viral expression. Methods We conducted a comprehensive search in PubMed, Ovid MEDLINE(R), Embase and Embase Classic and grey literature databases to identify studies reporting prevalence estimates of comorbidities in flavivirus diseases. Study quality was assessed with the risk of bias tool. Age-adjusted odds ratios (ORs) were estimated for severe infection in the presence of chronic comorbidities. Results We identified 65 studies as eligible for inclusion for DENV (47 studies) and WNV (18 studies). Obesity and overweight (i.e., BMI> 25 kg/m2, prevalence: 24.5%, 95% CI: 18.6–31.6%), hypertension (17.1%, 13.3–21.8%) and diabetes (13.3%, 9.3–18.8%) were the most prevalent comorbidities in DENV. However, hypertension (45.0%, 39.1–51.0%), diabetes (24.7%, 20.2–29.8%) and heart diseases (25.6%, 19.5–32.7%) were the most prevalent in WNV. ORs of severe flavivirus diseases were about 2 to 4 in infected patients with comorbidities such as diabetes, hypertension and heart diseases. The small number of studies in JEV, YFV and Zika did not permit estimating the prevalence of comorbidities in these infections. Conclusion Higher prevalence of chronic comorbidities was found in severe cases of flavivirus diseases compared to non-severe cases. Findings of the present study may guide public health practitioners and clinicians to evaluate infection severity based on the presence of comorbidity, a critical public health measure that may avert severe disease outcome given the current dearth of clear prevention practices for some flavivirus diseases.

Published
2017

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