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Neurologic outcome of VZV encephalitis one year after ICU admission: a multicenter cohort study

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  • معلومة اضافية
    • Contributors:
      Hopital Saint-Louis AP-HP (AP-HP); Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP); CHU Pitié-Salpêtrière AP-HP; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU); AP-HP - Hôpital Bichat - Claude Bernard Paris; CHU Henri Mondor Créteil; Centre Hospitalier de Versailles André Mignot (CHV); Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN); Université Claude Bernard Lyon 1 (UCBL); Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE); Hôpital Edouard Herriot CHU - HCL; Hospices Civils de Lyon (HCL); CHU Saint-Antoine AP-HP; Université Toulouse III - Paul Sabatier (UT3); Université de Toulouse (UT); Centre Hospitalier Universitaire de Toulouse (CHU Toulouse); Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy); Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé); Université de Versailles Saint-Quentin-en-Yvelines (UVSQ); Hôpital Ambroise Paré AP-HP; Université Paris-Saclay; Institut Mondor de Recherche Biomédicale (IMRB); Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12); Hôpital Nord CHU - APHM; Centre Hospitalier Régional Universitaire CHU Lille (CHRU Lille); Assistance Publique - Hôpitaux de Marseille (APHM); Centre hospitalier universitaire de Poitiers = Poitiers University Hospital (CHU de Poitiers La Milétrie ); Hôpital La Source Orléans (HLSO); Centre Hospitalier Emile Muller Mulhouse (CH E.Muller Mulhouse); Groupe Hospitalier de Territoire Haute Alsace (GHTHA); Université Paris Cité (UPCité); Centre Hospitalier Universitaire de Nantes = Nantes University Hospital (CHU Nantes)
    • بيانات النشر:
      HAL CCSD
      SpringerOpen
    • الموضوع:
      2022
    • Collection:
      Université de Versailles Saint-Quentin-en-Yvelines: HAL-UVSQ
    • نبذة مختصرة :
      International audience ; BACKGROUND: Varicella-zoster virus (VZV) is one of the main viruses responsible of acute encephalitis. However, data on the prognosis and neurologic outcome of critically ill patients with VZV encephalitis are limited. We aimed to describe the clinical features of VZV encephalitis in the ICU and to identify factors associated with a favorable neurologic outcome. We performed a multicenter cohort study of patients with VZV encephalitis admitted in 18 ICUs in France between 2000 and 2017. Factors associated with a favorable neurologic outcome, defined by a modified Rankin Score (mRS) of 0-2 1 year after ICU admission, were identified by multivariable regression analysis. RESULTS: Fifty-five patients (29 (53%) men, median age 53 (interquartile range 36-66)) were included, of whom 43 (78%) were immunocompromised. ICU admission occurred 1 (0-3) day after the onset of neurological symptoms. Median Glasgow Coma Score at ICU admission was 12 (7-14). Cerebrospinal fluid examination displayed a median leukocyte count of 68 (13-129)/mm(3), and a median protein level of 1.37 (0.77-3.67) g/L. CT scan and MRI revealed brain lesions in 30% and 66% of the cases, respectively. Invasive mechanical ventilation was implemented in 46 (84%) patients for a median duration of 13 (3-30) days. Fourteen (25%) patients died in the ICU. One year after ICU admission, 20 (36%) patients had a favorable neurologic outcome (mRS 0-2), 12 (22%) had significant disability (mRS 3-5), and 18 (33%) were deceased (lost to follow-up n = 5, 9%). On multivariable analysis, age (OR 0.92 per year, (0.88-0.97), p = 0.01), and invasive mechanical ventilation (OR 0.09 CI 95% (0.01-0.84), p = 0.03) reduced the likelihood of favorable neurologic outcome. CONCLUSION: One in every three critically ill patients with VZV encephalitis had a favorable neurologic outcome 1 year after ICU admission. Older age and invasive mechanical ventilation were associated with a higher risk of disability and death.
    • Relation:
      info:eu-repo/semantics/altIdentifier/pmid/35380296; inserm-03755209; https://inserm.hal.science/inserm-03755209; https://inserm.hal.science/inserm-03755209/document; https://inserm.hal.science/inserm-03755209/file/s13613-022-01002-y.pdf; PUBMED: 35380296; PUBMEDCENTRAL: PMC8982685
    • الرقم المعرف:
      10.1186/s13613-022-01002-y
    • Rights:
      info:eu-repo/semantics/OpenAccess
    • الرقم المعرف:
      edsbas.908B2214