Predictors of chronic arthralgia after chikungunya virus infection: a systematic review and meta-analysis.
Lucas Bussiki Corrêa da Costa Kotecki, Vitória Diniz de Medeiros, Mariana Bussiki Corrêa da Costa Kotecki et al.
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In 30 seconds
This systematic review and meta-analysis examined predictors of chronic arthralgia, defined as lasting at least 3 months, after laboratory-confirmed chikungunya infection. It included 29 studies with 4108 participants, of whom 1878 had chronic arthralgia. Across 22 pooled predictors, the most consistent associations were female sex (OR 2.08, 95% CI 1.77-2.46), comorbidity (OR 1.99, 95% CI 1.55-2.55) and high blood pressure (OR 1.52, 95% CI 1.13-2.04). Acute-phase manifestations and treatment-related markers had less stable associations. The authors report high risk of bias in most included studies.
Key findings
- Female sex was associated with chronic arthralgia (OR 2.08, 95% CI 1.77-2.46; I2 = 8.3%).
- Comorbidity presence was associated with chronic arthralgia (OR 1.99, 95% CI 1.55-2.55; I2 = 0%).
- High blood pressure was associated with chronic arthralgia (OR 1.52, 95% CI 1.13-2.04; I2 = 33.4%).
- Acute-phase manifestations and treatment-related markers showed less stable, timing-dependent or study-sensitive associations.
Why it matters
The findings suggest that persistent post-chikungunya joint symptoms may be more consistently associated with identifiable baseline host characteristics than with a uniform pattern of acute illness severity. This distinction may help frame risk assessment and follow-up planning, while the variable evidence for acute-phase predictors cautions against relying on symptom burden alone.
What to keep in mind
Risk of bias was high in most included studies and moderate in the remainder; associations from the pooled observational evidence do not establish causation.