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May 20, 2026Open Forum Infectious Diseases0 citationsOpen Access

Long-term sequelae associated with severe West Nile virus disease in Maricopa County, Arizona, 2021

AFAnna C. FagreCenters for Disease Control and Prevention KBKathryn G. BurrCenters for Disease Control and Prevention CMCedar L. MitchellUniversity of North Carolina at Chapel Hill

Key Points

This research aims to define the long-term outcomes associated with severe West Nile virus disease and compare them to patients with other infections.
A total of 159 patients with West Nile virus and 75 matched patients with other infectious diseases (COVID-19, coccidiomycosis) were assessed 17-24 months post-hospitalization.
Standardized assessment tools including modified Rankin Scale and 36-Item Short Form Survey were employed to evaluate patient outcomes.
Comparison of long-term sequelae and health status between WNV patients and comparators was conducted.
40% of WNV patients were transferred to long-term care facilities.
83% of WNV patients reported ongoing symptoms such as fatigue, pain, and cognitive issues.
33% of WNV patients reported disabilities, while 55% indicated worse health than before their illness.

Abstract

Abstract West Nile virus (WNV)-specific long-term sequelae (LTS) are not well-defined. We assessed LTS in patients hospitalized with WNV disease and compared their outcomes to an age- and sex-matched cohort of patients hospitalized with other infectious diseases. A total of 159 patients with WNV disease and 75 patients with predominantly COVID-19 and coccidiomycosis completed standardized assessment tools (modified Rankin Scale, modified CDC Symptom Inventory Checklist, and 36-Item Short Form Survey) 17–24 months after hospitalization. Among patients with WNV, 40% were transferred to long-term care facilities and 83% experienced ongoing symptoms, including fatigue, myalgia, arthralgia, pain, and problems with sleep, memory, and concentration. Overall, 33% reported disabilities and 55% reported worse health than before illness. The hospitalized infectious disease comparators reported similar LTS but had worse adjusted physical composite scores and a higher proportion reporting poor or fair health. LTS in patients hospitalized with WNV were common up to 2 years after hospitalization, but similar findings to comparators suggest there might be common inflammatory or other physiologic pathways leading to post-infectious sequelae or outcomes related to hospitalization. Providers caring for patients hospitalized with WNV should make patients and caregivers aware of the prolonged and possible incomplete recovery process.

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