Long-Term Survival, Health, Social Functioning, and Education in Patients With an Enterovirus Central Nervous System Infection, Denmark, 1997–2016

Author:

Omland Lars H1ORCID,Holm-Hansen Charlotte2,Lebech Anne-Mette1,Dessau Ram B3,Bodilsen Jacob45ORCID,Andersen Nanna S6,Roed Casper1,Christiansen Claus B7,Ellermann-Eriksen Svend8,Midgley Sofie2,Nielsen Lene9,Benfield Thomas10,Hansen Ann-Brit E110,Andersen Christian Ø11,Rothman Kenneth J1213,Sørensen Henrik T1213,Fischer Thea K21415,Obel Niels1

Affiliation:

1. Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark

2. Department of Virus and Specialist Microbiological Diagnostics, Statens Serum Institute, Copenhagen, Denmark

3. Department of Clinical Microbiology, Slagelse Hospital, Slagelse, Denmark

4. Department of Clinical Microbiology, Aalborg University Hospital, Aalborg, Denmark

5. Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark

6. Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark

7. Department of Clinical Microbiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark

8. Department of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark

9. Department of Clinical Microbiology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark

10. Department of Infectious Diseases, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark

11. Department of Clinical Microbiology, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark

12. Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark

13. Department of Epidemiology, Boston University, Boston, Massachusetts, USA

14. Department of Infectious Diseases, University of Southern Denmark, Odense, Denmark

15. Centre for Global Health, University of Southern Denmark, Odense, Denmark

Abstract

Abstract Background The long-term clinical course of patients with an enterovirus central nervous system infection (ECI) is poorly understood. Methods We performed a nationwide population-based cohort study of all Danish patients with ECI diagnosed 1997–2016 (n = 1745) and a comparison cohort from the general population individually matched on date of birth and sex (n = 17 450). Outcomes were categorized into mortality and risk of cancer and likely measures of neurological sequelae: neuropsychiatric morbidities, educational landmarks, use of hospital services, employment, receipt of disability pension, income, number of sick leave days, and nursing home residency. Results Mortality in the first year was higher among patients with ECI (mortality rate ratio [MRR] = 10.0; 95% confidence interval [CI], 4.17–24.1), but thereafter mortality was not higher (MMR = 0.94; 95% CI, 0.47–1.86). Long-term outcomes for patients with ECI were not inferior to those of the comparison cohort for risk of cancer, epilepsy, mental and behavioral disorders, dementia, depression, school start, school marks, high school education, use of hospital services, employment, receipt of disability pension, income, days of sick leave, or nursing home residency. Conclusions Diagnosis of an ECI had no substantial impact on long-term survival, health, or social/educational functioning.

Funder

Independent Research Fund Denmark

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Immunology and Allergy

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