Predictors of chronic joint pain after Chikungunya virus infection in the INOVACHIK prospective cohort study

•Musculoskeletal symptoms are not the only determinants of chikungunya chronic pain.•Early chikungunya RNA detection in saliva and urine are predictors of chronic pain.•Diarrhea in the acute phase of chikungunya infection is associated with chronic pain. Chikungunya can cause persistent chronic joint pain. Knowledge of the risk factors for disease progression is important for preventing and controlling complications. This study aimed to identify factors associated with chronic joint pain. This prospective cohort study was conducted at a reference center in Rio de Janeiro. Men and women (aged ≥ 18 years) in the acute phase of Chikungunya were included. Clinical data and samples were collected over three months. Risk factors were evaluated using multivariate and logistic regression analyses. A total of 107 patients were followed up. The incidence rate of joint tenderness was 61.7 %. Female sex (adjusted odds ratio [AOR] 3.24, 95 % confidence interval [CI]:1.07–9.77), diarrhea (AOR 5.08, 95 % CI:1.55–16.67), severe joint pain (AOR 4.26, 95 % CI:1.06–17.06), and CHIKV real-time reverse transcription polymerase chain reaction positivity up to 5 days after the onset of symptoms in urine or saliva (AOR 4.56, 95 % CI:1.41–14.77) were identified as predictors of persistent chronic pain. In a predominantly female population, musculoskeletal symptoms are not the sole determinant of chronic pain, and careful evaluation of CHIKV detection in alternative body fluids (such as saliva and urine) during the early phase of the disease is warranted.