BACKGROUND: Respiratory complications are uncommon, but often
life-threatening features of Plasmodium vivax malaria. This
study aimed to estimate the prevalence and lethality associated
with such complications among P. vivax malaria patients in a
tertiary hospital in the Western Brazilian Amazon, and to
identify variables associated with severe respiratory
complications, intensive care need and death. Medical records
from 2009 to 2016 were reviewed aiming to identify all patients
diagnosed with P. vivax malaria and respiratory complications.
Prevalence, lethality and risk factors associated with WHO
defined respiratory complications, intensive care need and death
were assessed. RESULTS: A total of 587 vivax malaria patients
were hospitalized during the study period. Thirty (5.1%)
developed respiratory complications. Thirteen (43.3%) developed
severe respiratory complications, intensive care was required
for 12 (40%) patients and 5 (16.6%) died. On admission, anaemia
and thrombocytopaenia were common findings, whereas fever was
unusual. Patients presented different classes of parasitaemia
and six were aparasitaemic on admission. Time to respiratory
complications occurred after anti-malarials administration in 18
(60%) patients and progressed very rapidly. Seventeen patients
(56.7%) had comorbidities and/or concomitant conditions, which
were significantly associated to higher odds of developing
severe respiratory complications, need for intensive care and
death (p < 0.05). CONCLUSION: Respiratory complications were
shown to be associated with significant mortality in this
population. Patients with comorbidities and/or concomitant
conditions require special attention to avoid this potential
life-threatening complication