Omland LH, Holm-Hansen C, Lebech AM, Dessau RB, Bodilsen J, Andersen NS, Roed C, Christiansen CB, Ellermann-Eriksen S, Midgley S, Nielsen L, Benfield T, Hansen AE, Anderson CO, Rothman KJ, Sorensen HT, Fischer TK, Obel N. Long-term survival, health, social functioning, and education in patients with an enterovirus central nervous system infection, Denmark, 1997-2016. J Infect Dis. 2020 Jul 23;222(4):619-27. doi: 10.1093/infdis/jiaa151

BACKGROUND: The long-term clinical course of patients with an enterovirus central nervous system infection (ECI) is poorly understood.

METHODS: We performed a nationwide population-based cohort study of all Danish patients with an ECI diagnosed during 1997-2016 (n=1745 patients) and a comparison cohort from the general population individually matched on date of birth and sex (n=17,450). Outcomes were categorized into mortality and risk of cancer and likely measures of neurological sequelae including neuropsychiatric morbidities, educational landmarks, use of hospital services, employment, receipt of disability pension, income, number of sick leave days and nursing home residency.

RESULTS: Mortality in the first year was increased among patients with ECI (mortality rate ratio=10.0, 95% CI: 4.17 - 24.1), but thereafter mortality was not increased (mortality rate ratio=0.94, 95% CI: 0.47 - 1.86). The long-term outcomes for patients with ECI were not inferior to those of the comparison cohort what concerns risk of cancer, epilepsy, mental and behavioral disorders, dementia, depression, school start, school marks, high school education, use of hospital services, employment, receipt of disability pension, income, days of sick leave, or nursing home residency.

CONCLUSIONS: A diagnosis of an ECI had no substantial impact on long-term survival, health, or social/educational functioning.