Lack of Additional Benefit with High Doses of Corticosteroids Among Patients with Chikungunya Viral Infection in the Subacute Phase

Background: Scientific evidence regarding the best dose of corticosteroids for the treatment for Chikungunya virus (CHIKV) infection in the subacute phase to relieve symptoms is lacking. Objectives: This study aimed to evaluate the effect of corticosteroid therapy on the treatment of subacute Chikungunya. Methods: This prospective cohort study involved patients with subacute CHIKV treated at the Tropical Medicine Center of Pará Federal University, Brazil. The data were collected between January 2019 and January 2020 during the following two periods: the initial consultation of patients and the return visit. A physical examination, in which the occurrence of inflammatory signs was checked and the number of painful and swollen joints was evaluated, was performed by a rheumatologist. Results: Data from 65 subjects were analysed with a predominance of females (80%), a mean age of 53.5±13.5 years and a disease duration of 50.0±20.8 days. In this study, 75.4% of the patients used corticosteroids, 73.8% of whom progressed to chronic disease and 26.2% of whom were cured. Although the re-evaluation consultation showed evident improvement in the initial symptoms, the use of a cumulative dose of corticosteroids above 350 mg of prednisone did not affect the outcomes compared to doses less than or equal to 350mg of prednisone. Conclusion: In conclusion, for patients infected with CHIKV in the subacute phase, doses of prednisone above 350 mg do not affect the outcome, and the preference for the use of corticosteroids at the lowest dose for the shortest possible time should be reinforced.