Prognosis after West Nile virus infection.
BACKGROUND
The long-term prognosis of patients infected with West Nile virus is not well understood.


OBJECTIVE
To describe the patterns of physical and mental function after infection with West Nile virus and to determine factors associated with recovery.


METHODS
Longitudinal cohort study.


METHODS
Data were collected during home visits and from ambulatory clinics in 4 Canadian provinces.


METHODS
156 persons with West Nile virus infection.


METHODS
Scores on the Physical Component Summary and Mental Component Summary of the Short Form-36, Depression Anxiety Stress Scale, and Fatigue Severity Scale.


RESULTS
Physical and mental function, as well as mood and fatigue, seemed to return to normal within 1 year of symptom onset. Participants with neuroinvasive disease took slightly longer to recover. Maximum predicted recovery or rate of recovery in any domain did not differ between participants with meningoencephalitis and those with encephalitis. Lack of preexisting comorbid conditions was associated with faster recovery of physical function, whereas lack of comorbid conditions and male sex were associated with faster recovery of mental function.


CONCLUSIONS
The analysis excluded 7 patients who died shortly after diagnosis, so the study's estimates of prognosis may be overoptimistic. The authors did not formally assess neuropsychological difficulties. The estimates of recovery are relative to the U.S. population, not to participants' function levels before West Nile virus infection.


CONCLUSIONS
Physical and mental outcome measures seem to normalize within approximately 1 year in patients with West Nile virus. The presence of preexisting comorbid conditions is associated with longer recovery.
Loeb
Mark
M
McMaster University, MDCL 3200, 1200 Main Street West, Hamilton, Ontario L8N 3Z5, Canada. loebm@mcmaster.ca
Hanna
Steven
S
Nicolle
Lindsay
L
Eyles
John
J
Elliott
Susan
S
Rathbone
Michel
M
Drebot
Michael
M
Neupane
Binod
B
Fearon
Margaret
M
Mahony
James
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000209:etiology; D018792:Encephalitis, Viral / Q000175:diagnosis; D005221:Fatigue / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008587:Meningitis, Viral / Q000175:diagnosis; D008875:Middle Aged; D010243:Paralysis / Q000175:diagnosis / Q000821:virology; D011379:Prognosis; D016016:Proportional Hazards Models; D020127:Recovery of Function; D013997:Time Factors; D014901:West Nile Fever / Q000503:physiopathology* / Q000523:psychology*