Non-specific symptoms and post-treatment Lyme disease syndrome in patients with Lyme borreliosis : a prospective cohort study in Belgium (2016–2020)

Background Patients with Lyme borreliosis (LB) may report persisting non-specific symptoms such as fatigue, widespread musculoskeletal pain or cognitive difficulties. When present for more than 6 months and causing a reduction in daily activities, this is often referred to as post-treatment Lyme dis...

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Hauptverfasser: Geebelen, Laurence, Lernout, Tinne, Devleesschauwer, Brecht, Kabamba-Mukadi, Benoît, Saegeman, Veroniek, Belkhir, Leïla, De Munter, Paul, Dubois, Bénédicte, Westhovens, Rene, Van Oyen, Herman, Speybroeck, Niko, Tersago, Katrien, Giot, Jean-Baptiste, Léonard, Philippe, Vangheluwe, Riet, Wieërs, Grégoire, Marot, Jean-Christophe, Evrard, Frédéric, Delaere, Bénédicte, Noirhomme, Séverine, Binnemans, Els, Vanhoof, Johan, Humtick Hospital Group, [missing]
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creator Geebelen, Laurence
Lernout, Tinne
Devleesschauwer, Brecht
Kabamba-Mukadi, Benoît
Saegeman, Veroniek
Belkhir, Leïla
De Munter, Paul
Dubois, Bénédicte
Westhovens, Rene
Van Oyen, Herman
Speybroeck, Niko
Tersago, Katrien
Giot, Jean-Baptiste
Léonard, Philippe
Vangheluwe, Riet
Wieërs, Grégoire
Marot, Jean-Christophe
Evrard, Frédéric
Delaere, Bénédicte
Noirhomme, Séverine
Binnemans, Els
Vanhoof, Johan
Humtick Hospital Group, [missing]
description Background Patients with Lyme borreliosis (LB) may report persisting non-specific symptoms such as fatigue, widespread musculoskeletal pain or cognitive difficulties. When present for more than 6 months and causing a reduction in daily activities, this is often referred to as post-treatment Lyme disease syndrome (PTLDS). This study aimed to compare the occurrence of symptoms between LB patients and controls, to estimate the proportion of LB patients developing PTLDS and to identify risk factors. Methods A prospective cohort study was set up including three subpopulations: patients with an erythema migrans (EM) (i) or disseminated/late LB (ii) and a non-LB control group (iii). At 6- and 12-months follow-up, the occurrence of several symptoms, including six symptoms used to define PTLDS, i.e. muscle pain, joint pain, fatigue, memory problems, difficulties concentrating and problems finding words, and impact on daily activities, was compared between LB patients and controls. Finally, the proportion of LB patients developing PTLDS as defined by the Infectious Disease Society of America was estimated, including a time frame for symptoms to be present. Results Although the risk of presenting PTLDS-related symptoms was significantly higher in EM patients (n = 120) compared to controls (n = 128) at 6 months follow-up, the risk of presenting at least one of these symptoms combined with impact on daily activities was not significantly higher in EM patients, at either 6- or 12-months follow-up. A significant association was found between disseminated/late LB (n = 15) and the occurrence of any PTLDS-symptom with an impact on daily activities at both time points. The proportion of patients with PTLDS was estimated at 5.9% (95% CI 2.7-12.9) in EM patients and 20.9% (95% CI 6.8-64.4) in patients with disseminated/late LB (RR = 3.53, 95% CI 0.98-12.68, p = 0.053). No significant risk factors were identified, which may be explained by small sample sizes. Conclusions In our study, PTLDS was present in both LB cohorts, yet with a higher percentage in disseminated/late LB patients. Additional research is needed into risk factors for and causes of this syndrome. In addition, development and validation of standardized methods to assess the PTLDS case definition, easily applicable in practice, is of great importance.
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When present for more than 6 months and causing a reduction in daily activities, this is often referred to as post-treatment Lyme disease syndrome (PTLDS). This study aimed to compare the occurrence of symptoms between LB patients and controls, to estimate the proportion of LB patients developing PTLDS and to identify risk factors. Methods A prospective cohort study was set up including three subpopulations: patients with an erythema migrans (EM) (i) or disseminated/late LB (ii) and a non-LB control group (iii). At 6- and 12-months follow-up, the occurrence of several symptoms, including six symptoms used to define PTLDS, i.e. muscle pain, joint pain, fatigue, memory problems, difficulties concentrating and problems finding words, and impact on daily activities, was compared between LB patients and controls. Finally, the proportion of LB patients developing PTLDS as defined by the Infectious Disease Society of America was estimated, including a time frame for symptoms to be present. Results Although the risk of presenting PTLDS-related symptoms was significantly higher in EM patients (n = 120) compared to controls (n = 128) at 6 months follow-up, the risk of presenting at least one of these symptoms combined with impact on daily activities was not significantly higher in EM patients, at either 6- or 12-months follow-up. A significant association was found between disseminated/late LB (n = 15) and the occurrence of any PTLDS-symptom with an impact on daily activities at both time points. The proportion of patients with PTLDS was estimated at 5.9% (95% CI 2.7-12.9) in EM patients and 20.9% (95% CI 6.8-64.4) in patients with disseminated/late LB (RR = 3.53, 95% CI 0.98-12.68, p = 0.053). No significant risk factors were identified, which may be explained by small sample sizes. Conclusions In our study, PTLDS was present in both LB cohorts, yet with a higher percentage in disseminated/late LB patients. Additional research is needed into risk factors for and causes of this syndrome. In addition, development and validation of standardized methods to assess the PTLDS case definition, easily applicable in practice, is of great importance.</description><identifier>ISSN: 1471-2334</identifier><identifier>EISSN: 1471-2334</identifier><language>eng</language><subject>ANTIBIOTIC-TREATMENT ; DIAGNOSIS ; Disseminated Lyme borreliosis ; Erythema migrans ; F-36 ; HEALTH SURVEY ; Lyme borreliosis ; Medicine and Health Sciences ; NEUROBORRELIOSIS ; Persisting non-specific symptoms ; Post-treatment Lyme disease syndrome ; TERM-FOLLOW-UP ; THERAPY ; TRIALS</subject><creationdate>2022</creationdate><rights>Creative Commons Attribution 4.0 International Public License (CC-BY 4.0) info:eu-repo/semantics/openAccess</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,315,778,782,4012,27847</link.rule.ids></links><search><creatorcontrib>Geebelen, Laurence</creatorcontrib><creatorcontrib>Lernout, Tinne</creatorcontrib><creatorcontrib>Devleesschauwer, Brecht</creatorcontrib><creatorcontrib>Kabamba-Mukadi, Benoît</creatorcontrib><creatorcontrib>Saegeman, Veroniek</creatorcontrib><creatorcontrib>Belkhir, Leïla</creatorcontrib><creatorcontrib>De Munter, Paul</creatorcontrib><creatorcontrib>Dubois, Bénédicte</creatorcontrib><creatorcontrib>Westhovens, Rene</creatorcontrib><creatorcontrib>Van Oyen, Herman</creatorcontrib><creatorcontrib>Speybroeck, Niko</creatorcontrib><creatorcontrib>Tersago, Katrien</creatorcontrib><creatorcontrib>Giot, Jean-Baptiste</creatorcontrib><creatorcontrib>Léonard, Philippe</creatorcontrib><creatorcontrib>Vangheluwe, Riet</creatorcontrib><creatorcontrib>Wieërs, Grégoire</creatorcontrib><creatorcontrib>Marot, Jean-Christophe</creatorcontrib><creatorcontrib>Evrard, Frédéric</creatorcontrib><creatorcontrib>Delaere, Bénédicte</creatorcontrib><creatorcontrib>Noirhomme, Séverine</creatorcontrib><creatorcontrib>Binnemans, Els</creatorcontrib><creatorcontrib>Vanhoof, Johan</creatorcontrib><creatorcontrib>Humtick Hospital Group, [missing]</creatorcontrib><title>Non-specific symptoms and post-treatment Lyme disease syndrome in patients with Lyme borreliosis : a prospective cohort study in Belgium (2016–2020)</title><description>Background Patients with Lyme borreliosis (LB) may report persisting non-specific symptoms such as fatigue, widespread musculoskeletal pain or cognitive difficulties. When present for more than 6 months and causing a reduction in daily activities, this is often referred to as post-treatment Lyme disease syndrome (PTLDS). This study aimed to compare the occurrence of symptoms between LB patients and controls, to estimate the proportion of LB patients developing PTLDS and to identify risk factors. Methods A prospective cohort study was set up including three subpopulations: patients with an erythema migrans (EM) (i) or disseminated/late LB (ii) and a non-LB control group (iii). At 6- and 12-months follow-up, the occurrence of several symptoms, including six symptoms used to define PTLDS, i.e. muscle pain, joint pain, fatigue, memory problems, difficulties concentrating and problems finding words, and impact on daily activities, was compared between LB patients and controls. Finally, the proportion of LB patients developing PTLDS as defined by the Infectious Disease Society of America was estimated, including a time frame for symptoms to be present. Results Although the risk of presenting PTLDS-related symptoms was significantly higher in EM patients (n = 120) compared to controls (n = 128) at 6 months follow-up, the risk of presenting at least one of these symptoms combined with impact on daily activities was not significantly higher in EM patients, at either 6- or 12-months follow-up. A significant association was found between disseminated/late LB (n = 15) and the occurrence of any PTLDS-symptom with an impact on daily activities at both time points. The proportion of patients with PTLDS was estimated at 5.9% (95% CI 2.7-12.9) in EM patients and 20.9% (95% CI 6.8-64.4) in patients with disseminated/late LB (RR = 3.53, 95% CI 0.98-12.68, p = 0.053). No significant risk factors were identified, which may be explained by small sample sizes. Conclusions In our study, PTLDS was present in both LB cohorts, yet with a higher percentage in disseminated/late LB patients. Additional research is needed into risk factors for and causes of this syndrome. In addition, development and validation of standardized methods to assess the PTLDS case definition, easily applicable in practice, is of great importance.</description><subject>ANTIBIOTIC-TREATMENT</subject><subject>DIAGNOSIS</subject><subject>Disseminated Lyme borreliosis</subject><subject>Erythema migrans</subject><subject>F-36</subject><subject>HEALTH SURVEY</subject><subject>Lyme borreliosis</subject><subject>Medicine and Health Sciences</subject><subject>NEUROBORRELIOSIS</subject><subject>Persisting non-specific symptoms</subject><subject>Post-treatment Lyme disease syndrome</subject><subject>TERM-FOLLOW-UP</subject><subject>THERAPY</subject><subject>TRIALS</subject><issn>1471-2334</issn><issn>1471-2334</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>ADGLB</sourceid><recordid>eNqdjb1OxDAQhC0EEsfPO2wJRSTHiS45ShCIAlFdHznOXrIosSPvBpSOd0DiAXkSEkFBTTWrmW92jtQmzYs0MVmWH_-5T9UZ84vWaVGa3UZ9Pgef8IiODuSA52GUMDBY38AYWBKJaGVAL_A0DwgNMVrGBfRNDItBHkYrtAAMbyTdD1aHGLGnwMRwAxbGGNYNoVcEF7oQBVimZl7rt9i3NA1wZXS6_Xr_MNro6wt1crA94-WvnivzcL-_e0zabpmqeqojOitVsFTZ6LrlcTW1a1RjVRbbMt9l2b9K32OFZrc</recordid><startdate>2022</startdate><enddate>2022</enddate><creator>Geebelen, Laurence</creator><creator>Lernout, Tinne</creator><creator>Devleesschauwer, Brecht</creator><creator>Kabamba-Mukadi, Benoît</creator><creator>Saegeman, Veroniek</creator><creator>Belkhir, Leïla</creator><creator>De Munter, Paul</creator><creator>Dubois, Bénédicte</creator><creator>Westhovens, Rene</creator><creator>Van Oyen, Herman</creator><creator>Speybroeck, Niko</creator><creator>Tersago, Katrien</creator><creator>Giot, Jean-Baptiste</creator><creator>Léonard, Philippe</creator><creator>Vangheluwe, Riet</creator><creator>Wieërs, Grégoire</creator><creator>Marot, Jean-Christophe</creator><creator>Evrard, Frédéric</creator><creator>Delaere, Bénédicte</creator><creator>Noirhomme, Séverine</creator><creator>Binnemans, Els</creator><creator>Vanhoof, Johan</creator><creator>Humtick Hospital Group, [missing]</creator><scope>ADGLB</scope></search><sort><creationdate>2022</creationdate><title>Non-specific symptoms and post-treatment Lyme disease syndrome in patients with Lyme borreliosis : a prospective cohort study in Belgium (2016–2020)</title><author>Geebelen, Laurence ; Lernout, Tinne ; Devleesschauwer, Brecht ; Kabamba-Mukadi, Benoît ; Saegeman, Veroniek ; Belkhir, Leïla ; De Munter, Paul ; Dubois, Bénédicte ; Westhovens, Rene ; Van Oyen, Herman ; Speybroeck, Niko ; Tersago, Katrien ; Giot, Jean-Baptiste ; Léonard, Philippe ; Vangheluwe, Riet ; Wieërs, Grégoire ; Marot, Jean-Christophe ; Evrard, Frédéric ; Delaere, Bénédicte ; Noirhomme, Séverine ; Binnemans, Els ; Vanhoof, Johan ; Humtick Hospital Group, [missing]</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-ghent_librecat_oai_archive_ugent_be_87684933</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>ANTIBIOTIC-TREATMENT</topic><topic>DIAGNOSIS</topic><topic>Disseminated Lyme borreliosis</topic><topic>Erythema migrans</topic><topic>F-36</topic><topic>HEALTH SURVEY</topic><topic>Lyme borreliosis</topic><topic>Medicine and Health Sciences</topic><topic>NEUROBORRELIOSIS</topic><topic>Persisting non-specific symptoms</topic><topic>Post-treatment Lyme disease syndrome</topic><topic>TERM-FOLLOW-UP</topic><topic>THERAPY</topic><topic>TRIALS</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Geebelen, Laurence</creatorcontrib><creatorcontrib>Lernout, Tinne</creatorcontrib><creatorcontrib>Devleesschauwer, Brecht</creatorcontrib><creatorcontrib>Kabamba-Mukadi, Benoît</creatorcontrib><creatorcontrib>Saegeman, Veroniek</creatorcontrib><creatorcontrib>Belkhir, Leïla</creatorcontrib><creatorcontrib>De Munter, Paul</creatorcontrib><creatorcontrib>Dubois, Bénédicte</creatorcontrib><creatorcontrib>Westhovens, Rene</creatorcontrib><creatorcontrib>Van Oyen, Herman</creatorcontrib><creatorcontrib>Speybroeck, Niko</creatorcontrib><creatorcontrib>Tersago, Katrien</creatorcontrib><creatorcontrib>Giot, Jean-Baptiste</creatorcontrib><creatorcontrib>Léonard, Philippe</creatorcontrib><creatorcontrib>Vangheluwe, Riet</creatorcontrib><creatorcontrib>Wieërs, Grégoire</creatorcontrib><creatorcontrib>Marot, Jean-Christophe</creatorcontrib><creatorcontrib>Evrard, Frédéric</creatorcontrib><creatorcontrib>Delaere, Bénédicte</creatorcontrib><creatorcontrib>Noirhomme, Séverine</creatorcontrib><creatorcontrib>Binnemans, Els</creatorcontrib><creatorcontrib>Vanhoof, Johan</creatorcontrib><creatorcontrib>Humtick Hospital Group, [missing]</creatorcontrib><collection>Ghent University Academic Bibliography</collection></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Geebelen, Laurence</au><au>Lernout, Tinne</au><au>Devleesschauwer, Brecht</au><au>Kabamba-Mukadi, Benoît</au><au>Saegeman, Veroniek</au><au>Belkhir, Leïla</au><au>De Munter, Paul</au><au>Dubois, Bénédicte</au><au>Westhovens, Rene</au><au>Van Oyen, Herman</au><au>Speybroeck, Niko</au><au>Tersago, Katrien</au><au>Giot, Jean-Baptiste</au><au>Léonard, Philippe</au><au>Vangheluwe, Riet</au><au>Wieërs, Grégoire</au><au>Marot, Jean-Christophe</au><au>Evrard, Frédéric</au><au>Delaere, Bénédicte</au><au>Noirhomme, Séverine</au><au>Binnemans, Els</au><au>Vanhoof, Johan</au><au>Humtick Hospital Group, [missing]</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Non-specific symptoms and post-treatment Lyme disease syndrome in patients with Lyme borreliosis : a prospective cohort study in Belgium (2016–2020)</atitle><date>2022</date><risdate>2022</risdate><issn>1471-2334</issn><eissn>1471-2334</eissn><abstract>Background Patients with Lyme borreliosis (LB) may report persisting non-specific symptoms such as fatigue, widespread musculoskeletal pain or cognitive difficulties. When present for more than 6 months and causing a reduction in daily activities, this is often referred to as post-treatment Lyme disease syndrome (PTLDS). This study aimed to compare the occurrence of symptoms between LB patients and controls, to estimate the proportion of LB patients developing PTLDS and to identify risk factors. Methods A prospective cohort study was set up including three subpopulations: patients with an erythema migrans (EM) (i) or disseminated/late LB (ii) and a non-LB control group (iii). At 6- and 12-months follow-up, the occurrence of several symptoms, including six symptoms used to define PTLDS, i.e. muscle pain, joint pain, fatigue, memory problems, difficulties concentrating and problems finding words, and impact on daily activities, was compared between LB patients and controls. Finally, the proportion of LB patients developing PTLDS as defined by the Infectious Disease Society of America was estimated, including a time frame for symptoms to be present. Results Although the risk of presenting PTLDS-related symptoms was significantly higher in EM patients (n = 120) compared to controls (n = 128) at 6 months follow-up, the risk of presenting at least one of these symptoms combined with impact on daily activities was not significantly higher in EM patients, at either 6- or 12-months follow-up. A significant association was found between disseminated/late LB (n = 15) and the occurrence of any PTLDS-symptom with an impact on daily activities at both time points. The proportion of patients with PTLDS was estimated at 5.9% (95% CI 2.7-12.9) in EM patients and 20.9% (95% CI 6.8-64.4) in patients with disseminated/late LB (RR = 3.53, 95% CI 0.98-12.68, p = 0.053). No significant risk factors were identified, which may be explained by small sample sizes. Conclusions In our study, PTLDS was present in both LB cohorts, yet with a higher percentage in disseminated/late LB patients. Additional research is needed into risk factors for and causes of this syndrome. In addition, development and validation of standardized methods to assess the PTLDS case definition, easily applicable in practice, is of great importance.</abstract><oa>free_for_read</oa></addata></record>
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subjects ANTIBIOTIC-TREATMENT
DIAGNOSIS
Disseminated Lyme borreliosis
Erythema migrans
F-36
HEALTH SURVEY
Lyme borreliosis
Medicine and Health Sciences
NEUROBORRELIOSIS
Persisting non-specific symptoms
Post-treatment Lyme disease syndrome
TERM-FOLLOW-UP
THERAPY
TRIALS
title Non-specific symptoms and post-treatment Lyme disease syndrome in patients with Lyme borreliosis : a prospective cohort study in Belgium (2016–2020)
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