Table 1 Selected articles for the study and main findings

2007

Borgherini et al.

Clin Infect Dis

Cross-sectional

Study of 157 patients with acute CHIK, showed that 52 of them had diabetes mellitus (DM) as comorbidity. Most of them were over 45 years of age, of these, 41% required hospitalization due to worsening of the viral infection, giving a significant higher rate of hospitalization OR (p = 0.008, OR 2.8 CI 1.32–5.94)

2009

Economopou-lou et al.

Epidemiol Infect

Cross-sectional

The study included 610 cases with an incidence rate of atypical CHIK 112/100,000 inhabitants, of whom 89% had associated comorbidities. DM was the second most reported comorbidity (39%). Further the results also showed that, of the total cases, 131 patients presented glycemic imbalance and 27 (20%) of them were diagnosed with DM for the first time. Of the 147 severe atypical cases with neurological disorders, 24% were diabetic. And those patients with severe cardiac conditions (n = 226), 48% had diabetes. Patients aged 40–60 years had a 2.5-fold higher risk of developing atypical forms of CHIK, while older patients 60 years and above had 1.6-fold higher risks in addition

2009

Staikowsky et al.

PLoSOne

Prospective

Patients with acute CHIKV were divided into two groups: active viremia and no viremia. It was observed that patients with active viremia had more comorbidities, mainly DM = 44/180 (24.4%) as compared to 8/34 (33.3%) without viremia. Female patients had frequent comorbidities (p < 0.05) as opposed to male patients. It was also observed that patients who required hospitalization were older and had more comorbidities (p < 0.001)

2009

Tandale et al.

J ClinVirol

Prospective

The study described cases of CHIK patients in two cities classified as classic, severe, and severe with neurological damage. Of 149 patients, DM was present only in severe cases (4/25) and in severe cases with neurological damage (4/10 and 15/59)

2009

Sissoko et al.

PLoSNeglTropDis

Restrospective cohort

The search for rheumatic manifestations in patients with CHIK were followed retrospectively. The results showed that of 147 patients confirmed with CHIKV, 32 had DM as comorbidity (OR 2.3, 0.9–5.3). In addition, the study showed that 84 patients remained with symptoms of rheumatic arthritis. Comorbidity was more common in these patients (OR 3.0, 1.5–5.9)

2012

Couturier et al.

Rheumatology

Prospective cohort

This was a prospective cohort analysis of the quality of life of patients with CHIK. Results showed that of 377 patients, 227 (60%) had associated comorbidities, OR 0.71 (0.57, 0.88), p > 0.002. Of these, 23 had DM

2015

Tolokh et al.

Am. J. Trop. Med. Hyg

Case report

Case report of a 50-year-old Puerto Rican man with diabetes with acquired acute Chikungunya virus infection. The patient evolved with atypical characteristics and severe manifestations such as leucopenia, thrombocytopenia, increased glycemic levels and ketone bodies, hepatic enzyme alterations, which culminated in the developmentof the diabetic ketoacidosis

2016

Crosby et al.

Int J Infect Dis

Cross-sectional

In a cross-sectional study of 65 patients with severe CHIKV admitted to Intensive Care Units, 54 had comorbidities (83%); DM wasthe second most prevalent comorbidity (32%). The study also showed that most diabetic patients did not have classic symptoms of Chikungunya, but may hadmore severe forms of the disease (p = 0.01)

2016

Jean-baptiste et al.

Am. J. Trop. Med. Hyg

Cohort

The only study that showed a direct relationship of DM in hospitalized patients with CHIKV, in the acute phase of the disease. It was found that diabetic patients worsened CHIK condition (p < 0.002) and presented greater arthralgia, fever and myalgia than non-diabetic patients (p < 0.008). Only diabetes was identified as a significant contributor to the presence of the triad of arthralgia, fever and myalgia (p = 0.002), time to improve arthralgia (p < 0.001) and duration of fever (p = 0.002). Diabetic patients had longer hospital stay (p < 0.0001) and a mean increase in glycaemia of 26.8% (p < 0.0001) when compared to baseline. Forty percent of diabetic patients required adjustment of the drug dose during the course of infection

2016

Perti et al.

Plos

Cross-sectional

The study reported that of 180 patients with CHIK, 71 had DM, and these patients had a higher risk for hospitalization, due to worsening of the condition (RR: 1.53; CI 95% 1.15–2.03). When adjusted for age the risk was 1.39 (1.06–1.84) (p = 0.02)

2016

Rollé et al.

EmergInfectDis

Cross-sectional

Diabetes mellitus was the most cited comorbidity in patients with severe CHIK 16/42 and non-severe CHIK 28/68