Survival Analysis, Long-Term Outcomes, and Percentage of Recovery up to 8 Years Post-Infection among the Houston West Nile Virus Cohort
Open accessAbstract
In 2012, we witnessed a resurgence of West Nile virus (WNV) in the United States, with the largest outbreak of human cases reported since 2003. WNV is now endemic and will continue to produce epidemics over time, therefore defining the long-term consequences of WNV infection is critical. Over a period of eight years, we prospectively followed a cohort of 157 WNV-infected subjects in the Houston metropolitan area to observe recovery over time and define the long-term clinical outcomes. We used survival analysis techniques to determine percentage of recovery over time and the effects of demographic and co-morbid conditions on recovery. We found that 40% of study participants continued to experience symptoms related to their WNV infection up to 8 years later. Having a clinical presentation of encephalitis and being over age 50 were significantly associated with prolonged or poor recovery over time. Since the health and economic impact as a result of prolonged recovery, continued morbidity, and related disability is likely substantial in those infected with WNV, future research should be aimed at developing effective vaccines to prevent illness and novel therapeutics to minimize morbidity, mortality, and long-term complications from infection.
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Permanent cognitive dysfunction after infectious encephalitis can occur without neuroinvasion, with cognitive deficits worsening over time.
“Permanent cognitive dysfunction after infectious encephalitis can occur without neuroinvasion, with cognitive deficits worsening over time [237].”
From Microglia and monocytes in inflammatory CNS disease: integrating phenotype and function (2022) · cites this paper as [237]
The Results (page unavailable) report memory loss among patient-reported symptoms at one and two years, and the Discussion reports persistent symptoms years after WNV infection, including poorer recovery among patients classified as having uncomplicated fever. But the Discussion cautions that some fever cases may have been misclassified neuroinvasive disease. The paper does not establish permanent cognitive dysfunction without neuroinvasion or worsening cognitive deficits over time; it reports that recovery plateaued around two years. (LLM, conf=0.86)
Experimental — accuracy not yet measuredMovement disorders persist for months to years in WNE patients.
“Movement disorders persist for months to years [83, 87–91].”
From Cognitive decline following acute viral infections: literature review and projections for post-COVID-19 (2022) · cites this paper as [87]
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- Authors
- Murray, K. O., Garcia, M. N., Rahbar, M. H., Martinez, D., Khuwaja, S. A., Arafat, R. R., & Rossmann, S.
- Affiliations
- Baylor College of Medicine (US)
- The University of Texas Health Science Center at Houston (US)
- Houston Health and Human Services Department (US)
- Corresponding author
- Murray, Kristy O.
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2014-07-23
- Volume
- 9
- Issue
- 7
- Pages
- e102953
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4108377
- OpenAlex
- W2037484801
- Cited by
- 103
- References
- 19
- Citations by year
- 2026: 5 · 2025: 12 · 2024: 7 · 2023: 10 · 2022: 11 · 2021: 11 · 2020: 7 · 2019: 10 · 2018: 6 · 2017: 5 · 2016: 5 · 2015: 9 · 2014: 2
- FWCI
- 6.97
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Gillson Longenbaugh Foundation
- National Institutes of Health
- U.S. Public Health Service (N01 50027, 266200500027C)
- National Institute of Allergy and Infectious Diseases (AI057341, R01AI091816, K23AI057341, AI U19 089992, U19AI089992)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Mosquito-borne diseases and control
- Health Sciences › Medicine › Infectious Diseases › Viral Infections and Vectors
- Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
- Keywords
- West Nile virus, long-term outcomes, survival analysis, encephalitis, persistent symptoms, age over 50, comorbidities
- MeSH terms
- Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Child, Disease Outbreaks, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prognosis, Texas, West Nile Fever, Survival Analysis, Young Adult
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