Comorbid conditions as risk factors for West Nile neuroinvasive disease in Ontario, Canada: a population-based cohort study
Open Access
- 11 May 2022
- journal article
- research article
- Published by Cambridge University Press (CUP) in Epidemiology and Infection
- Vol. 150, e103
- https://doi.org/10.1017/s0950268822000887
Abstract
West Nile neuroinvasive disease (WNND) is a severe neurological illness that can result from West Nile virus (WNV) infection, with long-term disability and death being common outcomes. Although WNV arrived in North America over two decades ago, risk factors for WNND are still being explored. The objective of this study was to identify WNND comorbid risk factors in the Ontario population using a retrospective, population-based cohort design. Incident WNV infections from laboratory records between 1 January 2002 – 31 December 2012 were individually-linked to health administrative databases to ascertain WNND outcomes and comorbid risk factors. WNND incidence was compared among individuals with and without comorbidities using risk ratios (RR) calculated with log binomial regression.Three hundred and forty-five individuals developed WNND (18.3%) out of 1884 WNV infections. West Nile encephalitis was driving most associations with comorbidities. Immunocompromised (aRR 2.61 [95% CI 1.23–4.53]) and male sex (aRR 1.32 [95% CI 1.00–1.76]) were risk factors for encephalitis, in addition to age, for which each 1-year increase was associated with a 2% (aRR 1.02 [95% CI 1.02–1.03]) relative increase in risk. Our results suggest that individuals living with comorbidities are at higher risk for WNND, in particular encephalitis, following WNV infection.Keywords
Funding Information
- Canadian Institutes of Health Research (#148714)
- Canada Research Chairs (CRC-950-232429)
This publication has 40 references indexed in Scilit:
- Detecting chronic kidney disease in population-based administrative databases using an algorithm of hospital encounter and physician claim codesBMC Nephrology, 2013
- Medical Risk Factors for Severe West Nile Virus Disease, United States, 2008–2010The American Journal of Tropical Medicine and Hygiene, 2012
- Demographic and Clinical Factors Associated with Persistent Symptoms after West Nile Virus InfectionThe American Journal of Tropical Medicine and Hygiene, 2010
- Risk Factors for West Nile Virus Neuroinvasive Disease, California, 2005Emerging Infectious Diseases, 2007
- The Long-Term Outcomes of Human West Nile Virus InfectionClinical Infectious Diseases, 2007
- PEDIATRIC WEST NILE VIRUS INFECTION: NEUROLOGIC DISEASE PRESENTATIONS DURING THE 2002 EPIDEMIC IN CUYAHOGA COUNTY, OHIOThe Pediatric Infectious Disease Journal, 2006
- Follow-up of 2003 Human West Nile Virus Infections, Denver, ColoradoEmerging Infectious Diseases, 2006
- Risk factors for encephalitis and death from West Nile virus infectionEpidemiology and Infection, 2006
- Clinical Description and Follow-up Investigation of Human West Nile Virus CasesSouthern Medical Journal, 2005
- Severe West Nile Virus Disease in Healthy AdultsClinical Infectious Diseases, 2004