CVD, stroke risk skyrocket with severe herpes zoster in hospitalized older patients

  • Piazza MF & al.
  • Vaccines (Basel)
  • 10 ene. 2020

  • de Liz Scherer
  • Clinical Essentials
El acceso al contenido completo es sólo para profesionales sanitarios registrados. El acceso al contenido completo es sólo para profesionales sanitarios registrados.

Takeaway

  • Severe herpes zoster (HZ) requiring hospitalization may confer 10-fold higher risk for cerebral vasculopathy, 7-fold higher risk for nonarrhythmic myocardiopathy, and 5-fold higher risk for cardiovascular diseases (CVDs), excluding hypertension.

Why this matters

  • In light of significant effect of severe HZ on chronic diseases, consider vaccination in elderly, high-risk patients.

Key results

  • 437 hospitalized patients with HZ, 2622 non-HZ controls.
  • Hospitalization rates increased with age to >50 cases/100,000 residents in adults age ≥84 years.
  • Hospital length of stay was higher with HZ vs without (median, 9 vs 7 days; P<.001>
  • HZ cohort had higher prevalences vs non-HZ of:
    • Prior transplantation: 1.83% vs 0.34% (P<.001>
    • HIV positivity: 1.37% vs 0.04% (P<.001>
    • Autoimmune conditions: 4.12% vs 2.33% (P=.029); and
    • Rare diseases: 1.14% vs 0.31% (P=.013).
  • 6 months posthospitalization, with HZ vs non-HZ, increased incidence of:
    • CVD: 11.17% vs 2.09% (P<.001>
    • Cerebral vasculopathy: 6.13% vs 0.60% (P<.001>
    • Nonarrhythmic myocardiopathy: 4.31% vs 0.59% (P=.002); and
    • Neuropathy: 2.62% vs 0.56% (P=.033).

Study design

  • Retrospective cohort assessing effect of severe HZ (requiring hospitalization) on clinical disease progression, prevalence 6 months prehospitalization, and incidence at 6 months posthospitalization in older adults vs matched non-HZ controls.
  • Funding: None disclosed.

Limitations

  • Miscoding, data reporting errors possible.
  • No mild cases, less frail patients.
  • Data sensitivity low.