Clinical characteristics and sick leave associated with infectious mononucleosis in a real-world setting in Germany, 2021, Kap et al

[Andy]

Abstract

Infectious mononucleosis (IM), mainly caused by the Epstein-Barr virus, can result in prolonged symptoms. The objective of this study was to look at the length of sick leave, diagnosis of IM, treatment, and comorbidities in a real-world setting in Germany. This retrospective, cross-sectional study used electronic medical record data from office-based practices in Germany and included patients with an initial confirmed diagnosis of IM between the January 1, 2016 and December 31, 2018. Patients of working age (18-65 years) with statutory health insurance were included in order to look at the working population who would need a sick note for their employers in case of illness. Epstein-Barr virus was the most common cause of IM in this population of 1,596 patients with an average age of 32 years. The majority of patients were female in all cohorts (~60%). Although CFS, myocarditis, and thrombocytopenia were not recorded frequently around the index date, the occurrence did increase during the follow-up period. Around half of patients received antibiotics. 62% of all patients were on sick leave for an average of 20 calendar days around the time of their IM diagnosis. Only 1% were still on sick leave after 6 months. A small percentage of patients remained on continuous sick leave after 6 months, suggesting that the long-term effect of IM on the ability to work was minor in our cohort. However, patients could still be experiencing symptoms that influence their quality of life.

Paywall, https://onlinelibrary.wiley.com/doi/10.1111/ijcp.14690

 

[Dolphin]

What’s known

• Infectious mononucleosis (IM) can result in prolonged symptoms.
• Chronic fatigue syndrome can be a complication of IM. IM patients can be treated with antibiotics, steroids or antiviral drugs.

What’s new

• Only a small proportion of IM patients received treatment with steroids or antiviral drugs.
• Of all patients diagnosed with IM, 62% were on sick leave during the time around the IM diagnosis.
• On average, patients were on sick leave for 20 days, but only 1% were still on sick leave after 6 months.
• Chronic fatigue syndrome was diagnosed in over 11% of patients in the year after the IM diagnosis.

The complications investigated included chronic fatigue syndrome (CFS) (ICD-10:F48)

The majority of patients were female in all cohorts (~60%). CFS, myocarditis and thrombocytopenia were not recorded frequently around the index date (Table 1). CFS was diagnosed in 1.4% of all patients, and
less than 1% of patients were diagnosed with myocarditis or thrombocytopenia.

CFS was diagnosed in over 11% of patients in the year after the IM diagnosis and occurred most often in patients with IM caused by the EBV virus (Table 3). The frequency of myocarditis and thrombocytopenia increased than that during the index period. However, myocarditis only occurred in 2.1% of patients and thrombocytopenia in 1.4% of all IM patients.

The last paragraph doesn't match table 3 where the percentages are lower. It's possible they somewhere mentioned that only some people were looked at for the year period: I haven't read the paper closely.