Prediction of unfavorable outcomes in West Nile virus neuroinvasive infection – Result of a multinational ID-IRI study

Background: WNV causes 1.4% of all central nervous system infections and is the most common cause of epidemic neuro-invasive disease in humans. Objectives: Our main objective was to investigate retrospectively West Nile virus neuroinvasive disease (WNND) cases hospitalized during 2010–2017 and identified factors that can influence prognosis. Study design: We documented the demographic, epidemiologic, clinical and laboratory data of WNND and identified factors that can influence prognosis. The data were recruited through Infectious Diseases International Research Initiative (ID-IRI), which serves as a network for clinical researches. Results: We investigated 165 patients with WNND in 10 countries from three continents. 27 patients died and the mortality rate was 16.4%. In an univariate analysis age, congestive heart failure, neoplasm and ischemic heart disease (p < 0.001), neuropsychiatric disorders (p = 0.011), chronic hepatitis (p = 0.024) and hypertension (p = 0.043) were risk factors for death. Fatal evolution was also correlated with ICU addmission, disorientation, speech disorders, change in consciousnes, coma, a low Glasgow coma score, obtundation, confusion (p < 0.001), history of syncope (p = 0.002) and history of unconsciousness (p = 0.037). In a binomial logistic regresssion analysis only age and coma remained independent prediction factors for death. We created an equation that was calculated according to age, co-morbidities and clinical manifestations that may be used to establish the prognosis of WNND patients. Conclusions: WNND remain an important factor for morbidity and mortality worldwide, evolution to death or survival with sequelae are not rare. Our study creates an equation that may be used in the future to establish the prognosis of WNND patients

Multiple sclerosis registries in Europe – An updated mapping survey

There are significant geographical differences with the highest prevalence occurring in Northern Europe and North America (over 100/100,000) as compared to 2/100,000 in Japan . MS patients are typically diagnosed between the ages of 20 and 50 years and will in most cases be expected to live for a long time with MS. The value of MS registries for MS patients, health care providers and regulators is becoming increasingly recognised . The collection of patient data into a registry can benefit the patients by enabling the clinician to prospectively follow the individual patient concerning disease progression, treatment response and side effects, and other parameters including patient reported outcomes (PRO) measures . From a societal viewpoint there are also many advantages of using data from MS registries, especially within areas of epidemiology and treatment studies, such as post marketing effectiveness, comparative or post-authorisation safety studies . This was recognised by regulatory bodies in the EU resulting in the first EMA-Workshop on MS-Registries in July 2017 in London . Therefore it is important to improve and promote the collection of safety data by MS registries as this might provide an opportunity for the MS registries to replace the typical drug specific post-authorization safety studies