Neurological complications associated with emerging viruses in Brazil

Submitted by Fátima Lopes ([email protected]) on 2020-06-03T15:02:05Z No. of bitstreams: 1 NeurologicalComplications.pdf: 923126 bytes, checksum: 2769ef625c3549984b377b229767f8b9 (MD5)Approved for entry into archive by Fátima Lopes ([email protected]) on 2020-06-04T19:13:45Z (GMT) No. of bitstreams: 1 NeurologicalComplications.pdf: 923126 bytes, checksum: 2769ef625c3549984b377b229767f8b9 (MD5)Made available in DSpace on 2020-06-04T19:13:45Z (GMT). No. of bitstreams: 1 NeurologicalComplications.pdf: 923126 bytes, checksum: 2769ef625c3549984b377b229767f8b9 (MD5) Previous issue date: 2020Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Departamento de Endemias Samuel Pessoa. Rio de Janeiro, RJ, Brasil.University of California Los Angeles. Institute of the Environment and Sustainability. Los Angeles, CA, USA.Fundação Oswaldo Cruz. Escola Politécnica de Saúde Joaquim Venâncio. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Departamento de Endemias Samuel Pessoa. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Departamento de Endemias Samuel Pessoa. Rio de Janeiro, RJ, Brasil.Universidade Federal Fluminense. Departamento de Neurologia. Niterói, RJ, Brasil.Universidade Federal Fluminense. Departamento de Neurologia. Niterói, RJ, Brasil.Universidade Federal do Piauí. Departamento de Ciência Política. Teresina, PI, Brasil.UCLA School of Medicine. Los Angeles, CA, USA.Universidade Federal Fluminense. Departamento de Neurologia. Niterói, RJ, Brasil.Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Departamento de Endemias Samuel Pessoa. Rio de Janeiro, RJ, Brasil.Objective: To test the hypotheses that emerging viruses are associated with neurological hospitalizations and that statistical models can be used to predict neurological sequelae from viral infections. Methods: An ecological study was carried out to observe time trends in the number of hospitalizations with inflammatory polyneuropathy and Guillain-Barré syndrome (GBS) in the state of Rio de Janeiro from 1997 to 2017. Increases in GBS from month to month were assessed using a Farrington test. In addition, a cross-sectional study was conducted analyzing 50 adults hospitalized for inflammatory polyneuropathies from 2015 to 2017. The extent to which Zika virus symptoms explained GBS hospitalizations was evaluated using a calibration test. Results: There were significant increases (Farrington test, P<0.001) in the incidence of GBS following the introduction of influenza A/H1N1 in 2009, dengue virus type 4 in 2013, and Zika virus in 2015. Of 50 patients hospitalized, 14 (28.0%) were diagnosed with arboviruses, 9 (18.0%) with other viruses, and the remainder with other causes of such neuropathies. Statistical models based on cases of emerging viruses accurately predicted neurological sequelae, such as GBS. Conclusion: The introduction of novel viruses increases the incidence of inflammatory neuropathies