Retrospective evaluation of the clinical and demographic characteristics of herpes zoster cases followed up in our clinic during the Covid-19 pandemic

Year 2024, Volume: 15 Issue: 1, 45 - 55, 28.03.2024

Işıl Göğem İmren Şule Subaşı Gökşin

https://doi.org/10.18663/tjcl.1388554

Abstract

Aim: In our study, which included both pediatric and adult patients; we aimed to contribute to the follow-up of patients by evaluating the two-year demographic and clinical data of Herpes Zoster patients who were followed and treated in the dermatovenerology clinic of a secondary level hospital.
Material and Methods: In this cross-sectional study, the clinic and epidemiological records of patients who were clinically diagnosed with herpes zoster in the Denizli State Hospital Dermatovenerology outpatient clinic between October 2020 and October 2022 were evaluated retrospectively.
Results: The age range was between 2 and 94 among 289 HZ patients, and the mean age was 52.12 ±22.635 years. Fifty-three percent were female and 47 % were male. While the 18-65 age group was the most crowded group with 166 (57.43%) patients, there were 33 (11.41%) patients under the age of 18. A history of predisposing factors was found in 85.1% of the patients. Stress was detected the most common predisposing factor in adults and infections in childhood. A history of an additional systemic comorbidity was found in %69.2 of the patients, and additional dermatologic comorbidity was found in %68.1 of the patients. Complications were found in 60.2% of the patients, and 52.6% had postherpetic neuralgia. It was observed that 9% of the patients were hospitalized.
Conclusion: In our study, we determined the clinical and epidemiological data of HZ patients we followed in Denizli during the years under the influence of the COVID-19 pandemic, and the risk factors associated with HZ complications. We consider that morbidity and mortality caused by complications can be significantly reduced by informing the society about disease, vaccinating risk groups, early appointment to hospital, appropriate treatment, close follow-up and hospitalization when necessary.

Keywords

Herpes zoster, epidemiology, postherpetic neuralgia, COVID-19

Kliniğimizde Covid-19 pandemisi döneminde takip edilen herpes zoster olgularının klinik ve demografik özelliklerinin retrospektif değerlendirilmesi

Abstract

Amaç: Hem pediatrik hem de erişkin hastaları içeren çalışmamızda kliniğimizde takip ve tedavi edilen Herpes Zoster olgularının demografik ve klinik özelliklerini inceleyerek, hastaların izlemine katkı sunmayı amaçladık.
Yöntemler: Bu kesitsel çalışmada, ikinci basamak bir hastanenin Deri ve Zührevi Hastalıklar polikliniğinde, Ekim 2020-Ekim 2022 tarihleri arasında, klinik olarak herpes zoster tanısı alan hastaların klinik ve epidemiyolojik verileri retrospektif olarak değerlendirilmiştir.
Bulgular: Çalışmaya dahil edilen 289 hastanın %53’ü kadın, %47’si erkek, ortalama yaş 52.12 (±22,635), median yaş 58 (2-94) bulundu. 18-65 yaş aralığı 166 (%57,43) hasta ile en kalabalık grubu oluştururken, 18 yaş altı 33 (%11,41) hasta bulunmaktaydı. En sık tutulan bölge torakal dermatom (%37,4) olarak saptandı. Hastaların %85,1’ inde tetikleyici faktör öyküsü saptandı. Yetişkinlerde stres, çocukluk çağında ise enfeksiyonlar en sık tespit edilen tetikleyici faktörlerdi. Hastaların %69, 2 ’sinde sistemik komorbidite , %68.1’inde dermatolojik komorbidite bulunmaktaydı. En sık görülen komplikasyon postherpetik nevralji (%42.6) olmak üzere tüm hastaların %60, 2 ’sinde HZ’a dair komplikasyonlar tespit edildi. Hastaların %9’u
hospitalize edilerek tedavi edildi.
Sonuç: COVID-19 pandemisinin etkisi altındaki bu yıllarda Denizli ilinde takip ettiğimiz HZ hastalarına dair klinik ve epidemiyolojik verileri ve HZ komplikasyonları ile ilişkili risk faktörlerini belirlemeye yönelik olarak yaptığımız çalışmamızın sonucunda; toplumun HZ hastalığı hakkında bilgilendirilmesi, riski grupların aşılanması, zamanında başvuru, uygun tedavinin erken dönemde düzenlenmesi, gerekli hallerde hospitalizasyon ve yakın takip ile komplikasyonların yaratacağı morbidite ve mortalitenin belirgin ölçüde azaltılabileceğini düşünmekteyiz.

Keywords

Herpes zoster, epidemiyoloji, postherpetic nevralji, COVID-19.

Ethical Statement

Çalışma için Pamukkale Üniversitesi Girişimsel Olmayan Klinik Araştırmalar Etik kurulundan onay alındı (18.10.2022 E-60116787-020-278878). Çalışmaya katılan tüm gönüllülere çalışma hakkında bilgi verilerek aydınlatılmış onamları alındı. Çalışma Helsinki bildirgesi prensiplerine uygun bir şekilde yürütüldü.

Supporting Institution

Bu araştırma hiçbir kurum ve kuruluş tarafından finansal olarak desteklenmemiştir.

References

• Yawn BP, Gilden D. The global epidemiology of herpes zoster. Neurology 2013;81(10):928-30. PMID: 23999562
• Johnson RW. Herpes zoster and postherpetic neuralgia. Expert Rev Vaccines. 2010;9(3 Suppl):21-6. PMID: 20192714
• Pinchinat S, Cebrian-Cuenca AM, Bricout H, Johnson RW. Similar herpes zoster incidence across Europe: results from a systematic literature review. BMC Infect Dis. 2013;13:170. PMID: 23574765
• Koshy E, Mengting L, Kumar H, Jianbo W. Epidemiology, treatment and prevention of herpes zoster: A comprehensive review. Indian J Dermatol Venereol Leprol. 2018;84(3):251-62. PMID: 29516900
• Johnson RW, Alvarez-Pasquin MJ, Bijl M, Franco E, Gaillat J, Clara JG, Labetoulle M, Michel JP, Naldi L, Sanmarti LS, Weinke T. Herpes zoster epidemiology, management, and disease and economic burden in Europe: a multidisciplinary perspective. Ther Adv Vaccines. 2015 Jul;3(4):109-20. PMID: 26478818
• Weinberg JM. Herpes zoster: Epidemiology, natural history, and common complications. J Am AcadDermatol. 2007; 57(6 SUPPL.): 130–5. PMID: 18021864
• Bollea-Garlatti ML, Bollea-Garlatti LA, Vacas AS, Torre AC, Kowalczuk AM, Galimberti RL, Ferreyro BL. Clinical Characteristics and Outcomes in a Population With Disseminated Herpes Zoster: A Retrospective Cohort Study. Actas Dermosifiliogr. 2017 Mar;108(2):145-152. PMID: 27938930
• Thomas SL, Hall AJ. What does epidemiology tell us about risk factors for herpes zoster? Lancet Infect Dis. 2004 Jan;4(1):26-33. PMID: 14720565
• Elsaie ML, Youssef EA, Nada HA. Herpes zoster might be an indicator for latent COVID 19 infection. Dermatol Ther. 2020 Jul;33(4):e13666. PMID: 32447801
• Català A, Muñoz-Santos C, Galván-Casas C, et al.: Cutaneous reactions after SARS-CoV-2 vaccination: a cross-sectional Spanish nationwide study of 405 cases. Br J Dermatol. 2022 Jan;186(1):142-152. PMID: 34254291
• Temiz SA, Abdelmaksoud A, Wollina U, Kutlu O, Dursun R, Patil A, Lotti T, Goldust M, Vestita M. Cutaneous and Allergic reactions due to COVID-19 vaccinations: A review. J Cosmet Dermatol. 2022 Jan;21(1):4-12. PMID: 34791757
• Harbecke R, Cohen JI, Oxman MN. Herpes Zoster Vaccines. J Infect Dis. 2021 Sep 30;224(12 Suppl 2):S429-S442. PMID: 34590136
• Goksin S, Imren IG, Cenk H, Kacar N, Duygulu S. The Effects of Changing Lifestyle and Daily Behaviours in the First Months of COVID-19 Outbreak on Dermatological Diseases: Retrospective Cross-Sectional Observational Study. Turkiye Klinikleri J Dermatol. 2022;32(1):47-55
• Lin YH, Huang LM, Chang IS, Tsai FY, Lu CY, Shao PL, Chang LY; Varicella-Zoster Working Group; Advisory Committee on Immunization Practices, Taiwan. Disease burden and epidemiology of herpes zoster in pre-vaccine Taiwan. Vaccine. 2010; Feb 3;28(5):1217-20. PMID: 19944790
• Brisson M, Edmunds WJ, Law B, Gay NJ, Walld R, Brownell M, Roos LL, De Serres G. Epidemiology of varicella zoster virus infection in Canada and the United Kingdom. Epidemiol Infect. 2001; Oct;127(2):305-14. PMID: 11693508
• Küçükçakır O, Aliağaoğlu C, Turan H, Yanık ME, Gürlevik Z, Acer E, Albayrak H, Gönen İ. Retrospective evaluation of patients with herpes zoster followed up in our department between 1999-2010. Turkderm-Turk Arch Dermatol Venereol. 2012; 46(4): 186-190
• Özkol HU, Bilgili SG,Karadağ AS,Altun F,Çalka Ö. Türkiye'nin doğusundaki Herpes Zoster tanılı 115 hastanın klinik ve demografik özelliklerinin değerlendirilmesi.Turk J Dermatol. 2013; 7: 201-5.
• Kutlu Ö, Metin A. Relative changes in the pattern of diseases presenting in dermatology outpatient clinic in the era of the COVID-19 pandemic. Dermatol Ther. 2020;Nov;33(6):e14096.
• Demirel Öğüt N, Tabak GH, Gülseren D, Yalıcı-Armağan B, Akdoğan N, Doğan S, Elçin G, Karaduman A, Ersoy Evans S. The effect of the COVID-19 pandemic on dermatology consultation requests from adult and paediatric emergency departments. Int J Clin Pract. 2021;Dec;75(12):e14906. PMID: 34553467
• Kim YJ, Lee CN, Lim CY, Jeon WS, Park YM. Population-based study of the epidemiology of herpes zoster in Korea. J Korean Med Sci. 2014;29(12):1706-10. PMID: 25469074
• Kawai K, Gebremeskel BG, Acosta CJ. Systematic review of incidence and complications of herpes zoster: towards a global perspective. BMJ Open. 2014;4(6):e004833. PMID: 24916088
• Hayran Y, Akpınar Ü, Yalçın B. Herpes Zoster Tanısıyla Takip Edilen Hastaların Demografik, Klinik ve Laboratuvar Özelliklerinin Değerlendirilmesi. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. 2020; 53(Ek Sayı 1): 33-40.
• Lu WH, Lin CW, Wang CY, Chen LK, Hsiao FY. Epidemiology and long-term disease burden of herpes zoster and postherpetic neuralgia in Taiwan: a population-based, propensity score matched cohort study. BMC Public Health. 2018;18(1):369. PMID: 29554872
• Toyama N, Shiraki K; Society of the Miyazaki Prefecture Dermatologists. Epidemiology of herpes zoster and its relationship to varicella in Japan: A 10-year survey of 48,388 herpes zoster cases in Miyazaki prefecture. J Med Virol. 2009; Dec;81(12):2053-8. PMID: 19856466
• Grassly NC, Fraser C. Seasonal infectious disease epidemiology. Proc Biol Sci. 2006; Oct 7;273(1600):2541-50. PMID: 16959647
• Atsü AN , Oruc Adalı G , Caf N , Türkoglu Z. Evaluation of Demographic and Clinical Data of Herpes Zoster Patients Admitted To Tertiary Referral Dermatology Clinic During COVID-19 Pandemic. Dicle Tıp Dergisi. 2022; 49(1): 111-118
• Kalaycı B. Çocukluk çağı herpes zosterde predispozan faktörler ve klinik özellikler: retrospektif bir çalışma. Ege Tıp Dergisi. 2022; 61(3): 417 - 424.
• Aktaş H, Erdal SA, Güvenç U. Herpes Zoster in children: Evaluation of the sixty cases. Dermatologic Therapy. 2021; 32(6):e13087. PMID: 31515892
• Schimdt SA, Mor A, Schonheyder HC, Dekkers OM, Cronin-Fenton D: Herpes zoster as a marker of occult cancer: A systematic review and meta-analysis. J Infect 2017; 74(3):215-235. PMID: 27845154