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Abstract
Chronic rheumatological manifestations similar to those of rheumatoid arthritis (RA) are described after chikungunya virus infection. We aimed to compare the relevance of joint counts and symptoms to clinical outcomes in RA and chronic chikungunya disease. Forty patients with chronic chikungunya arthralgia and 40 patients with RA were enrolled in a cross-sectional study. The association of tenderness and swelling, clinically assessed in 28 joints, and patient evaluations of pain and musculoskeletal stiffness with modified Health Assessment Questionnaire (HAQ) and quality of life (QoL) assessments were investigated. Tender and swollen joint counts, pain and stiffness scores were all associated with the HAQ disability index in RA (all r > 0.55, p ≤ 0.0002), but only stiffness was significantly associated with disability in chikungunya (r = 0.38, p = 0.02). Joint counts, pain and stiffness were also associated with most QoL domains in RA patients. In contrast, in chikungunya disease, tender joint counts were associated only with one QoL domain and swollen joints for none, while pain and stiffness were associated with several domains. Our results confirm the relevance of joint counts in RA, but suggest that in chronic chikungunya disease, joint counts have more limited value. Stiffness and pain score may be more important to quantify chikungunya arthritis impact.
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1 Evotec ID, Department of Virology, Lyon, France; Aarhus University, Departments of Clinical Pharmacology, Hepatology and Gastroenterology, Aarhus, Denmark (GRID:grid.7048.b) (ISNI:0000 0001 1956 2722)
2 Universidade Federal de Roraima, Laboratorio de Parasitologia e Vetores da Amazonia, Curso de Enfermagem, Centro de Ciencias da Saude, Boa Vista, Brazil (GRID:grid.440579.b) (ISNI:0000 0000 9908 9447)
3 Instituto Leônidas e Maria Deane, FIOCRUZ, Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Manaus, Brazil (GRID:grid.418068.3) (ISNI:0000 0001 0723 0931)
4 Aptuit (Verona) Srl, Biometry Department, Verona, Italy (GRID:grid.418068.3)
5 George Washington University, Department of Medicine, Washington, USA (GRID:grid.253615.6) (ISNI:0000 0004 1936 9510)
6 University of California San Diego, Department of Medicine, San Diego, USA (GRID:grid.266100.3) (ISNI:0000 0001 2107 4242)
7 George Washington University, School of Medicine and Health Sciences, Washington, USA (GRID:grid.253615.6) (ISNI:0000 0004 1936 9510)