Clinical characteristics and outcomes of measles outbreak in adults: A multicenter retrospective observational study of 93 hospitalized adults in Greece
| العنوان: | Clinical characteristics and outcomes of measles outbreak in adults: A multicenter retrospective observational study of 93 hospitalized adults in Greece |
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| المؤلفون: | Helen Sambatakou, Dimitra Kavvatha, Maria Pirounaki, Styliani Sympardi, Emmanouil Karofylakis, Paraskevi C. Fragkou, Sotirios Tsiodras, Konstantinos Thomas, Theodoros Marantos, George D. Liatsos, Spyridon P. Dourakis |
| المصدر: | Journal of Clinical Virology |
| بيانات النشر: | Elsevier BV, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Adult, Male, 0301 basic medicine, ARDS, Pediatrics, medicine.medical_specialty, Adolescent, 030106 microbiology, Hospitalized, Antiviral Agents, Measles, Article, C-reactive protein, Miscarriage, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Risk Factors, Lymphopenia, Virology, Ribavirin, medicine, Humans, Adults, 030212 general & internal medicine, ComputingMethodologies_COMPUTERGRAPHICS, Retrospective Studies, Pneumonitis, Past medical history, Greece, business.industry, Liver Diseases, Vaccination, Retrospective cohort study, Pneumonia, Middle Aged, medicine.disease, Pulmonary embolism, Abortion, Spontaneous, Hospitalization, Treatment Outcome, Infectious Diseases, Measles virus, Female, business |
| الوصف: | Graphical abstract Highlights • Measles is an unresolved issue for unvaccinated or incompletely vaccinated adults. • Data for outcomes, complications and risk factors in adults are limited. • Pneumonitis and hepatic involvement are the most frequent complications in adults. • Older age, low lymphocyte count and male sex are associated with pneumonitis. • Case fatality ratio in adults is low despite the high frequency of complications. Objectives Measles outbreaks are increasingly reported among countries that were close-to-eliminate measles infection. There are few reports of clinical characteristics of measles in adults in the contemporary literature. In this study we aim to describe the clinical characteristics and complications of measles infection in hospitalized adults during the recent epidemic in Greece. Methods A multicentre observational retrospective study was conducted in three tertiary hospitals in Greece. All adult hospitalized patients (≥18 years old) with serologically confirmed and/or clinical features compatible with measles were included. Pediatric patients and patients with missing data were excluded. Results In total, 93 patients, 40 males (43 %) and 53 females (57 %), mostly young patients were included. Most of them (87 %) had no past medical history. Among women, 4 were pregnant. 56 (60.2 %) and 25 (26.9 %) patients reported either unknown or incomplete vaccination for measles. Ribavirin was administered in 8 (8.6 %) patients. Pneumonitis and hepatic involvement were the most common complications, occurring in 43 (46.2 %) and 75 (80.6 %) patients respectively. Pneumonitis was significantly associated with male sex, older age, lower lymphocyte counts and higher C-reactive protein (CRP) on admission. One pregnant woman suffered spontaneous fetal miscarriage and one patient died due to acute respiratory distress syndrome (ARDS) and high-risk pulmonary embolism. Conclusion Considerable proportions of incompletely vaccinated or unvaccinated adults have led to the re-emergence of measles in countries with reported close-to-elimination rates. Pneumonitis is a major complication among adults with measles. More studies are imperative in order to explore the role of immune paresis in measles. |
| تدمد: | 1386-6532 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::44434da8a2fdbc319af0a809d649edefTest https://doi.org/10.1016/j.jcv.2020.104608Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....44434da8a2fdbc319af0a809d649edef |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 13866532 |
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