Clin Infect Dis. 2019 Nov 27. pii: ciz1158. doi: 10.1093/cid/ciz1158. [Epub ahead of print]
Long-term sequelae and health-related quality-of-life associated with Lyme disease: A systematic review.
Mac S1,2,
Bahia S3,
Simbulan F4,
Pullenayegum EM4,5,
Evans GA1,6,7,
Patel SN8,9,
Sander B1,2,7,8.
Author information
1
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
2
THETA Collaborative, University Health Network, Toronto, Canada.
3
Department of Biochemistry, University of Ottawa, Ottawa, Canada.
4
The Hospital for Sick Children (SickKids), Toronto, Canada.
5
Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
6
Department of Medicine, Queen's University, Kingston, Canada.
7
Institute of Clinical Evaluative Sciences, Toronto, Canada.
8
Public Health Ontario, Toronto, Canada.
9
Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada.
Abstract
Lyme disease (LD) is the most commonly reported vector-borne disease, but its clinical consequences remain uncertain. We conducted a systematic review of the long-term sequelae and health-related quality-of-life (HRQoL) associated with LD in North America and Europe. We performed searches in six electronic databases up to December 2018 following PRISMA guidelines, including observational studies reporting long-term sequelae, HRQoL, and prognostic factors. We included 46 studies, published between 1994 and 2019. Based on 21 studies reporting attributable outcomes, higher proportions of sequelae reported from exposed patients were: neck pain, myalgia, arthralgia, paresthesia, sleep disorder, poor appetite and concentration difficulties. Patients with PTLDS reported impaired HRQoL compared to the general US population. Included studies were highly heterogeneous in terms of study design, settings, patient characteristics and quality. Patients with LD are more likely to report non-specific long-term sequelae, especially those experiencing persistent symptoms post-treatment. Opportunities exist for prospective longitudinal studies to better understand LD outcomes.
© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail:
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KEYWORDS:
Borrelia burgdorferi; Lyme borreliosis; Lyme disease; quality-of-life; systematic review
PMID:
31773171
DOI:
10.1093/cid/ciz1158
