Hantavirus pulmonary syndrome: prognostic factors for death in reported cases in Brazil

• Published in: Transactions of the Royal Society of Tropical Medicine and Hygiene Vol. 106; no. 5; pp. 298 - 302
• Main Authors: da Rosa Elkhoury, Mauro, da Silva Mendes, Wellington, Waldman, Eliseu Alves, Dias, Juarez Pereira, Carmo, Eduardo Hage, Fernando da Costa Vasconcelos, Pedro
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.05.2012; Royal Society of Tropical Medicine and Hygiene; Oxford University Press
• Subjects: Adult; Adult respiratory distress syndrome; Biological and medical sciences; Brazil; Brazil - epidemiology; Cohort Studies; Dyspnea; Dyspnea - mortality; Dyspnea - physiopathology; Epidemiology; Female; General aspects; Hantavirus; Hantavirus - pathogenicity; Hantavirus pulmonary syndrome; Hantavirus Pulmonary Syndrome - diagnosis; Hantavirus Pulmonary Syndrome - mortality; Hantavirus Pulmonary Syndrome - physiopathology; Historical account; Hospitalization - statistics & numerical data; Human viral diseases; Humans; Infectious diseases; Male; Medical sciences; Mortality; Multiple regression analysis; Pneumology; Prevalence; Prognosis; Prognostic factors; Regression analysis; Respiration; Respiration, Artificial; Respiratory system : syndromes and miscellaneous diseases; Retrospective Studies; Risk Factors; Rural areas; Viral diseases; Viral diseases of the respiratory system and ent viral diseases; Winter; Young Adult; South America; Brazil; America; Brazil; Hantavirus; Hantavirus pulmonary syndrome; Epidemiology; Prognostic factors; Prognosis; Respiratory disease; Mortality; Infection; Virus; Bunyaviridae; Viral disease; Respiratory distress; Tropical medicine
• ISSN: 0035-9203; 1878-3503
• DOI: 10.1016/j.trstmh.2012.01.002

Hantavirus pulmonary syndrome (HPS) was described for the first time in Brazil in 1993 and has occurred endemically throughout the country. This study analysed clinical and laboratory aspects as well as death-related factors for HPS cases in Brazil from 1993 to 2006. The investigation comprised a descriptive and exploratory study of the history of cases as well as an analytical retrospective cohort survey to identify prognostic factors for death due to HPS. A total of 855 Brazilian HPS cases were assessed. The majority of cases occurred during spring (33.5%) and winter (27.6%), mainly among young male adults working in rural areas. The global case fatality rate was 39.3%. The mean interval between the onset of symptoms and hospitalisation was 4 days and that between hospitalisation and death was 1 day. In the multiple regression analysis, adult respiratory distress syndrome and mechanical respiratory support were associated with risk of death; when these two variables were excluded from the model, dyspnoea and haemoconcentration were associated with a higher risk of death.