title: Impaired quality of life after chikungunya virus infection: a 2-year follow-up study.
abstract: OBJECTIVE
  To measure the frequency of and risk factors for rheumatic manifestations after chikungunya virus (CHIKV) infection and to assess their impact on quality of life (QoL).
  
  
  METHODS
  In a cohort study among 509 cases diagnosed in France, demographic and clinical characteristics were collected at baseline, and QoL status by 36-item short-form health survey (SF-36), a short form of the Arthritis Impact Measurement Scales 2 (AIMS2-SF) and General Health Questionnaire (GHQ-12) at follow-up. SF-36 scores were compared with population norms. Factors associated with QoL were identified in multivariate linear regression models.
  
  
  RESULTS
  A total of 391 (77%) patients participated (53.5% female, mean age 50.2 years). Median time from onset at follow-up was 23.4 months. Among 176 recovered patients, a shorter duration of symptoms was observed in younger age groups and male patients. The probability of full recovery at 1 year was 0.39. Those not recovered were older, had more comorbidities and a longer acute stage with joint swelling. Scores of physical and mental components of the SF-36 and GHQ-12 were low. The AIMS2-SF was affected mainly in symptoms, psychological and social dimensions. Recovered patients did not differ significantly from age- and gender-matched population SF-36 norms. Older age (P = 0.01-0.002) was associated with lower SF-36 scores. Other factors associated with lower SF-36, lower GHQ12 scores and higher AIMS2-SF dimensions were lack of recovery (P = 0.017 to <0.0001), presence of comorbidity (P = 0.005 to <0.0001) and a longer duration of acute stage (P = 0.047 to <0.0001).
  
  
  CONCLUSIONS
  Medical follow-up with special attention to comorbidity providing information on possible chronic symptoms and giving support for potential depression and anxiety are recommended.
authors.affiliation: Département des Maladies Infectieuses, Institut de Veille Sanitaire, 12 rue du Val d'Osne, 94415 Saint-Maurice cedex, France. e.couturier@invs.sante.fr
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Couturier
authors.forename: Francis
authors.initials: F
authors.lastname: Guillemin
authors.forename: Marie
authors.initials: M
authors.lastname: Mura
authors.forename: Lucie
authors.initials: L
authors.lastname: Léon
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Virion
authors.forename: Marie-José
authors.initials: MJ
authors.lastname: Letort
authors.forename: Henriette
authors.initials: H
authors.lastname: De Valk
authors.forename: Fabrice
authors.initials: F
authors.lastname: Simon
authors.forename: Véronique
authors.initials: V
authors.lastname: Vaillant
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018354:Alphavirus Infections / Q000453:epidemiology / Q000534:rehabilitation* / Q000821:virology; D065632:Chikungunya Fever; D002646:Chikungunya virus / Q000302:isolation & purification*; D002648:Child; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D011159:Population Surveillance / Q000379:methods*; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult