Chronic Joint Pain 3 Years after Chikungunya Virus Infection Largely Characterized by Relapsing-remitting Symptoms.

OBJECTIVE: To determine the frequency of chronic joint pain and stiffness 3 years after infection with chikungunya virus (CHIKV) in a Latin American cohort. METHODS: A cross-sectional followup of 120 patients from an initial cohort of 500 patients who reported joint pain 2 years after infection from the Atlántico Department, Colombia. Patients were clinically diagnosed as having CHIKV during the 2014-2015 epidemic, and baseline and followup symptoms at 40 months were evaluated in serologically confirmed cases. RESULTS: Of the initial 500 patients enrolled in the study, 482 had serologically confirmed chikungunya infection. From this group, 123 patients reported joint pain 20 months after infection, and 54% of those patients reported continued joint pain 40 months after infection. Therefore, 1 out of every 8 people who tested serologically positive for CHIKV infection had persistent joint pain 3 years after infection. Participants who followed up in person were predominantly adult (mean ± SD age 51 ± 14 yrs) and female (86%). The most common type of pain reported in these patients at 40 months post-infection was pain with periods of relief and subsequent reoccurrence, and over 75% reported stiffness after immobility, with 39% experiencing morning stiffness. CONCLUSION: To our knowledge, this is the first report to describe persistent joint pain and stiffness 40 months after viral infection. The high frequency of chronic disease highlights the need to develop prevention and treatment methods. Further studies should be conducted to understand the similarities between post-chikungunya joint pain and rheumatoid arthritis.

Fracturas vertebrales morfométricas y su relación con 25 OH vitamina D, índice de masa corporal y edad en mujeres seniles / Morphometric vertebral fractures and their relationship with 25 OH-vitamin D, body mass index, and age in elderly women

Objetivo: Determinar la presencia de fracturas vertebrales morfométricas y su relación con 25 OH vitamina D, índice de masa corporal y edad en mujeres seniles. Materiales y métodos: Estudio transversal. Se analizaron 319 mujeres seniles, provenientes del estudio "Salud osteomuscular del anciano". La determinación de fracturas vertebrales morfométricas se realizó de manera radiográfica, en tanto que los niveles de 25 OH vitamina D se midieron por inmunoanálisis por quimioluminiscencia (CLIA) Liaison* 25 OH vitamina D Total Assay Ref 310600, utilizando el equipo Diasorin Liaison* Analyzer. El índice de masa corporal se obtuvo, según las recomendaciones de la Organización Mundial de la Salud, como el peso en kilogramos sobre la talla en metros al cuadrado; la edad fue verificada con el documento de identidad y el ingreso del mismo a las bases de datos nacionales (SISPRO-FOSYGA). Resultados: El promedio de edad fue de 74,3 arios (DE ± 7,2). La prevalencia global de fracturas fue de 17,9%; así mismo, el 54,9% de las participantes tenía valores entre 20 y 29ng/ml de 25 OH vitamina D y el 58,9% tenía valores de índice de masa corporal inferior a 25 kg/m². El promedio de 25 OH vitamina D fue inferior en las participantes fracturadas (19,7 vs. 25,1) (p<0,05); el índice de masa corporal también fue menor en las fracturadas (23,5 vs. 24,6) (p>0,05), pero la edad fue mayor: 78,9 vs. 73,4 (p<0,05). Al comparar los promedios de 25 OH vitamina D en participantes fracturadas y no fracturadas, se encontraron niveles significativamente menores de 25 OH vitamina D en las participantes con fractura mayores de 69 años, y al considerar el índice de masa corporal, los valores de 25 OH vitamina D fueron significativamente inferiores en cada una de las categorías de las participantes con fractura. Conclusión: Se encontró una relación estadísticamente significativa entre poseer fracturas vertebrales morfométricas y tener: 1) niveles bajos de 25 OH vitamina D, 2) mayor edad, y 3) menor índice de masa corporal.

Objective: To determine the presence of morphometric vertebral fractures, as well as their relationship with 25 OH vitamin D, body mass index, and age in elderly women. Materials and methods: A cross-sectional study was conducted on 319 elderly women from the study 'Musculoskeletal Health in the Elderly'. The morphometric determination of vertebral fractures was performed with radiography, while the levels of 25 OH vitamin D were determined by the chemiluminescent immunoassay (CLIA) method using the Liaison® 25 OH Vitamin D Total Assay 25 (Ref 310 600), using the Liaison® Analyser. The body mass index was obtained as recommended by the World Health Organisation; weight in kilograms over height in metres squared. The age of the participants was verified by their identity card, and their income details from the national data bases (SISPRO-FOSYGA). Results: The mean age was 74.3 years (SD ± 7.2). The overall prevalence of fractures was 17.9%; 54.9% of participants had values between 20 and 29ng/ml 25 OH vitamin D, and 58.9% had body mass index values less than 25 kg/m². The mean 25 OH vitamin D was lower in participants with fractures (19.7 vs. 25.1) (P < .05). Body mass index was also lower in those with fractures (23.5 vs. 24.6) (P < .05), but age was higher: 78.9 vs. 73.4 (P < .05). When comparing the mean levels of 25 OH vitamin D in fractured and non-fractured participants, significantly lower levels of 25 OH vitamin D were found in participants with fractures over 69 years-old, and on comparing the body mass index, the values of 25 OH vitamin D were significantly lower in each of the categories of participants with a fracture. Conclusion: A statistically significant relationship was found between morphometric vertebral fractures and: 1) low levels of 25 OH vitamin D, 2) being older and, and 3) a lower body mass index.