Berkay TEMEL, Ozge Mine ORENAY, Nermin KARAOSMANOĞLU

Clinical features of hospitalized herpes zoster patients and comparison of elderly patients with younger patients: tertiary care clinical experience

Aim Severalstudies were conducted to determine the characteristics of hospitalized patients withHerpes Zoster. This study aimed to evaluate the characteristics of hospitalized especially elderly patients with Herpes Zoster and compare them with young adult patients in tertiary clinic in Turkey. Material and Methods Hospitalized HZ patients were enrolled 2008 and 2020. Age, gender, length of hospitalization, affected dermatomes, treatment agents, comorbidities, complications were recorded from the electronic medical files. Results Totally 82 patients were evaluated.62.2% (n=51) of the patients were over 65 years old. In the group over 65 years of age, the proportion of female patients were 54.9% (n=28), cervical dermatome involvement was 49% (n=25), the most common comorbidity is hypertension, the proportion of comorbid patients was 92.2% (n=47), the proportion of immunosuppressive patients were 39.2% (n=20), the most common complication was acute neuralgia, the proportion of complicated patients was 68.6% (n=35), the most commonly used treatment agents were valacyclovir and NSAID. The mean length of hospital stay was 11.9 days. Conclusion Elderly hospitalized patients with HZ tend to be more complicated and have longer hospital stays. Therefore, early treatment is important in this group.

Anahtar Kelimeler:

herpes zoster, hospitalized, older

Clinical features of hospitalized herpes zoster patients and comparison of elderly patients with younger patients: tertiary care clinical experience.

Aim Several studies were conducted to determine the characteristics of hospitalized patients with Herpes Zoster. This study aimed to evaluate the characteristics of hospitalized especially elderly patients with Herpes Zoster and compare them with young adult patients in tertiary clinic in Turkey. Material and Methods Hospitalized HZ patients were enrolled 2008 and 2020. Age, gender, length of hospitalization, affected dermatomes, treatment agents, comorbidities, complications were recorded from the electronic medical files. Results Totally 82 patients were evaluated. 62.2% (n=51) of the patients were over 65 years old. In the group over 65 years of age, the proportion of female patients were 54.9% (n=28), cervical dermatome involvement was 49% (n=25), the most common comorbidity is hypertension, the proportion of comorbid patients was 92.2% (n=47), the proportion of immunosuppressive patients were 39.2% (n=20), the most common complication was acute neuralgia, the proportion of complicated patients was 68.6% (n=35), the most commonly used treatment agents were valacyclovir and NSAID. The mean length of hospital stay was 11.9 days. Conclusion Elderly hospitalized patients with HZ tend to be more complicated and have longer hospital stays. Therefore, early treatment is important in this group.

Keywords:

complication, neuralgia, valacyclovir,

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1. Shingles (Herpes Zoster). Centers for Disease Control and Prevention. Available from: https://www.cdc.gov/shingles/ surveillance.html. Accessed: February 18, 2022.
2. Kawai K., Yawn B.P., Wollan P., Harpaz R.: Increasing incidence of herpes zoster over a 60-year period from a population-based study. Clin Infect Dis 2016;63:221-226.
3. Thomas S.L., Hall A.J.: What does epidemiology tell us about risk factors for herpes zoster?. Lancet Infect Dis 2004;4:26-33.
4. Kawai K, Yawn BP. Risk Factors for Herpes Zoster: A Systematic Review and Meta-analysis. Mayo Clin Proc. 2017;92(12):1806-1821.
5. Dooling KL, Guo A, Patel M, et al. Recommendations of the advisory committee on immunization practices for use of herpes zoster vaccines. MMWR Morb Mortal Wkly Rep 2018; 67:103–8.
6. Johnson RW, Alvarez-Pasquin MJ, Bijl M, et al. Herpes zoster epidemiology, management, and disease and economic burden in Europe: a multidisciplinary perspective [published correction appears in Ther Adv Vaccines. 2016;4(1-2):32]. Ther Adv Vaccines. 2015;3(4):109-120.
7. García-Rojas A, Gil-Prieto R, Núñez-Gallo DÁ, Matute-Cruz P, Gil-de-Miguel A. Hospitalizations realted to herpes zoster infection in the Canary Islands, Spain (2005-2014). BMC Infect Dis. 2017;17(1):586.
8. Vukelić D, Oroši Končić D, Prepolec J, et al. Clinical characteristics of hospitalized adults and adolescents with herpes zoster in Croatia: more than 20 years of a single-center experience. Croat Med J. 2020;61(5):401-409.
9. Esteban-Vasallo MD, Domínguez-Berjón MF, Gil de Miguel Á, Astray-Mochales J, Blanco-Ancos LM, Gil-Prieto R. Characteristics of herpes zoster-associated hospitalizations in Madrid (SPAIN) before vaccine availability. J Infect. 2016;72(1):70-9.
10. Gil A, Gil R, Alvaro A, San Martín M, González A. Burden of herpes zoster requiring hospitalization in Spain during a seven-year period (1998-2004). BMC Infect Dis. 2009;9:55.
11. Piazza MF, Paganino C, Amicizia D, Trucchi C, Orsi A, Astengo M, Romairone P, Simonetti S, Icardi G, Ansaldi F. The Unknown Health Burden of Herpes Zoster Hospitalizations: The Effect on Chronic Disease Course in Adult Patients ≥50 Years. Vaccines (Basel). 2020;8(1):20.
12. John AR, Canaday DH. Herpes Zoster in the Older Adult. Infect Dis Clin North Am. 2017;31(4):811-826.
13. Hobbelen PH, Stowe J, Amirthalingam G, Miller L, van Hoek AJ. The burden of hospitalisation for varicella and herpes zoster in England from 2004 to 2013. J Infect. 2016;73(3):241-53.
14. Fleming DM, Cross KW, Cobb WA, Chapman RS. Gender difference in the incidence of shingles. Epidemiol Infect. 2004;132(1):1-5.
15. Nagel MA, Gilden D. Complications of varicella zoster virus reactivation. Curr Treat Options Neurol. 2013;15(4):439-453.
16. Kawai K, Gebremeskel BG, Acosta CJ. Systematic review of incidence and complications of herpes zoster: towards a global perspective. BMJ Open. 2014 Jun 10;4(6):e004833.