Reemerging arboviruses: clinical-epidemiological profile of hospitalized elderly patients

Viana, Lia Raquel de Carvalho; Pimenta, Cláudia Jeane Lopes; Araújo, Edna Marília Nóbrega Fonseca de; Teófilo, Tiago José Silveira; Costa, Tatiana Ferreira da; Costa, Kátia Neyla de Freitas Macedo

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Original Article • Rev. esc. enferm. USP 52 • 2018 • https://doi.org/10.1590/S1980-220X2017052103403 copy

Reemerging arboviruses: clinical-epidemiological profile of hospitalized elderly patients

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

Describe the clinical-epidemiological profile of hospitalized elderly patients with arbovirus.

Method:

A documentary retrospective population-based descriptive study that used a quantitative approach with hospitalized elderly patients diagnosed with arbovirus was conducted in a teaching hospital. Data were collected from medical records and investigation forms.

Results:

Thirty-three elderly patients participated in this study. A prevalence of dengue was observed, with fever, myalgia, and arthralgia. Arterial hypertension and diabetes were the comorbidities. Statistically significant correlations were obtained between arbovirus and schooling, employment situation, marital status, test results, and use of analgesics; and between the site of arthralgia and Chikungunya.

Conclusion:

The results support nursing care to hospitalized elderly patients with arbovirus, allowing the development of a proper and humanized care plan.

DESCRIPTORS
Aged; Dengue; Chikungunya Fever; Geriatric Nursing; Health of the Elderly

Baseline diseases	n	%
Systemic arterial hypertension	23	69.7
Diabetes	16	48.5
Cardiopathy	10	30.3
Hepatopathy	3	9.1
Chronic kidney disease	3	9.1
Respiratory disease	3	9.1
Ophthalmologic disease	3	9.1
Neurological disease	2	6.1
Autoimmune disease	1	3.0
Hematologic disease	1	3.0
None	2	6.1
Nothing on record	2	6.1

Variables		n	%
Signs and symptoms
	Fever	32	97.0
	Myalgia	26	78.8
	Severe arthritis	25	75.8
	Headache	21	63.6
	Nausea	14	42.4
	Vomiting	14	42.4
	Exanthema	13	39.4
	Asthenia	9	27.3
	Weight loss	9	27.3
	Diarrhea	8	24.2
	Back pain	6	18.2
	Pruritus	5	15.2
	Retro-orbital pain	3	9.1
	Conjunctivitis	2	6.1
	Edema	2	6.1
	Chills	1	3.0

Variables		Diagnosis / arbovirus				p value
		Dengue		Chikungunya
		n	%	n	%
Sex
	Male	12	66.7	7	46.7	0.247^* * Pearson's chi-square test;
	Female	6	33.3	8	53.3
Age group
	60 – 69 years	12	66.7	7	46.7
	70 – 79 years	3	16.7	3	20.0	0.240^ Mann-Whitney test.
	80 – 89 years	2	11.1	4	26.7
	≥ 90 years	1	5.6	1	6.7
Ethnic group
	White	6	33.3	6	40.0
	Brown/mulatto/caboclo	7	38.9	7	46.7	0.432^* * Pearson's chi-square test;
	Black	3	16.7	–	–
	Nothing on record	2	11.1	2	13.3
Schooling
	Illiterate	5	27.8	–	–
	Incomplete elementary education	5	27.8	2	13.3
	Complete elementary education	1	5.6	1	6.7
	Complete high school	3	16.7	2	13.3	0.002^ Mann-Whitney test.
	Incomplete high school	1	5.6	–	–
	Complete higher education	1	5.6	2	13.3
	Nothing on record	2	11.1	8	53.3
Employment situation
	Retired	11	61.1	2	13.3
	Pensioner	–	–	1	6.7
	Employed	5	27.8	2	13.3	0.008^* * Pearson's chi-square test;
	Housewife	1	5.6	3	20.0
	Nothing on record	1	5.6	7	46.7
Marital status
	Single	–	–	–	–
	Married	13	72.2	5	33.3
	Widowed	–	–	2	13.3	0.022^* * Pearson's chi-square test;
	Divorced	2	11.1	–	–
	Nothing on record	3	16.7	8	53.3
Dwelling area
	Urban	16	88.9	15	100.0
	Rural	1	5.6	–	–	0.412^* * Pearson's chi-square test;
	Nothing on record	1	5.6	–	–
Origin
	Urgency and emergency service	7	38.9	4	26.7
	Hospital care	5	27.8	2	13.3	0.370^* * Pearson's chi-square test;
	Residency	–	–	1	6.7
	Nothing on record	6	33.3	8	53.3
Total		18	100.0	15	100.0

Variables		Diagnosis / arbovirus				p value
		Dengue		Chikungunya
		n	%	n	%
Blood count
	Leukopenia	9	50.0	4	26.7	0.172^* * Pearson's chi-square test;
	Thrombocytopenia	2	11.1	1	6.7	0.658^* * Pearson's chi-square test;
	High C-reactive protein	12	66.7	4	26.7	0.037^ Fisher's exact test.
	Thrombocytopenia	15	83.3	7	46.7	0.026^* * Pearson's chi-square test;
	Reduced red blood cells	–	–	2	13.3	0.199^ Fisher's exact test.
	Reduced hemoglobin	1	5.6	4	26.7	0.152^ Fisher's exact test.
	Nothing on record	1	5.6	6	40.0	0.300^ Fisher's exact test.
Medications/treatment
	Analgesic drugs	17	94.4	9	60.0	0.030^ Fisher's exact test.
	Antipyretic drugs	15	83.3	9	60.0	0.239^* * Pearson's chi-square test;
	Corticosteroid drugs	–	–	1	6.7	0.455^ Fisher's exact test.
	Nonsteroidal anti-inflammatory drugs	–	–	1	6.7	0.455^ Fisher's exact test.
	Oral/intravenous hydration	13	72.2	7	46.7	0.135^* * Pearson's chi-square test;
	Anti-hypertensive drugs	9	50.0	6	40.0	0.566^* * Pearson's chi-square test;
	Hypoglycemic drug/insulin	7	38.9	3	20.0	0.283^ Fisher's exact test.
	Nothing on record	1	5.6	6	40.0	0.300^ Fisher's exact test.

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Lia Raquel de Carvalho Viana, Rua dos Milagres, 1516, Cristo Redentor, CEP 58070-530 – João Pessoa, PB, Brazil lia_viana19@hotmail.com