One-Year Sequelae and Quality of Life in Adults with Meningococcal Meningitis: Lessons from the COMBAT Multicentre Prospective Study

Xavier Duval, Muhamed-Kheir Taha, Isabelle Lamaury, Lélia Escaut, Isabelle Gueit, Pauline Manchon, Sarah Tubiana, Bruno Hoen, COMBAT study group, Xavier Duval, Bruno Hoen, Bruno Mourvillier, Marie-Cécile Ploy, Sarah Tubiana, Emmanuelle Varon, François Caron, Pierre-Edouard Bollaert, Olivier Gaillot, Muhamed-Kheir Taha, Claire Poyart, Stephane Bonacorsi, François Vandenesch, Emmanuelle Cambau, Marc Lecuit, Alain Gravet, Bruno Frachet, Thomas De Broucker, Daniel Levy Bruhl, François Raffi, Marie Preau, Nadia Anguel, Laurent Argaud, Sophie Arista, Laurence Armand-Lefevre, Stéphanie Balavoine, Régine Baraduc, Guilène Barnaud, Guillaume Beraud, Louis Bernard, Georges Bernars, Dominique Bertei, Emilie Bessede, Typhaine Billard Pomares, Charlotte Biron, Stéphane Bland, Julien Boileau, Patrice Boubeau, Sandra Bourdon, Aurore Bousquet, Sophie Boyer, Alexis Bozorg-Grayeli, Laurent Bret, Cédric Bretonniere, François Bricaire, Elsa Brocas, Michel Brun, Jennifer Buret, Christophe Burucoa, Jean Cabalion, Mathieu Cabon, Emmanuelle Cambau, Guillaume Camuset, Christophe Canevet, François Caron, Anne Carricajo, Bernard Castan, Eric Caumes, Charles Cazanave, Amélie Chabrol, Thibaut Challan-Belval, Vanessa Chanteperdrix-Marillier, Chantal Chaplain, Caroline Charlier-Woerther, Hélène Chaussade, Catherine Chirouze, Bernard Clair, Julien Colot, Jean-Marie Conil, Hugues Cordel, Philippe Cormier, Joël Cousson, Pierrick Cronier, Eric Cua, Anne Dao-Dubremetz, Sylvie Dargere, Nicolas Degand, Sophie Dekeyser, Deborah Delaune, Eric Denes, Pierre-Francois Dequin, Diane Descamps, Elodie Descloux, Jean-Luc Desmaretz, Jean-Luc Diehl, Jérôme Dimet, Aurélien Dinh Xavier Duval, Lelia Escaut, Claude Fabe, Frédéric Faibis, Clara Flateau, Nathalie Fonsale, Emmanuel Forestier, Nicolas Fortineau, Amandine Gagneux-Brunon, Caroline Garandeau, Magali Garcia, Denis Garot, Stéphane Gaudry, François Goehringer, Alain Gravet, Valérie Gregoire-Faucher, Marine Grosset, Camélia Gubavu, Isabelle Gueit, Dominique Guelon, Thomas Guimard, Jérôme Guinard, Tahar Hadou, Jean-Pierre Helene, Sandrine Henard, Benoit Henry, Anne-Cécile Hochart, Bruno Hoen, Gabriela Illes, Sylvain Jaffuel, Irène Jarrin, Françoise Jaureguy, Cédric Joseph, Marie-Emmanuelle Juvin, Samer Kayal, Solen Kerneis, Flore Lacassin, Isabelle Lamaury, Philippe Lanotte, Etienne Laurens, Henri Laurichesse, Cécile Le Brun, Vincent Le Moing, Paul Le Turnier, Hervé Lecuyer, Sylvie Ledru, Céline Legrix, Adrien Lemaignen, Chantal Lemble, Ludovic Lemee, Olivier Lesens, Marion Levast, Claire Lhommet, Silvija Males, Edith Malpote, Guillaume Martin-Blondel, Matthieu Marx, Raphael Masson, Olivier Matray, Aurore Mbadi, Frédéric Mechai, Guillaume Mellon, Audrey Merens, Marie Caroline Meyohas, Adrien Michon, Joy Mootien Yoganaden, David Morquin, Stéphane Mouly, Natacha Mrozek, Sophie Nguyen, Yohan Nguyen, Maja Ogielska, Eric Oziol, Bernard Page, Solène Patrat-Delon, Isabelle Patry, André Pechinot, Sandrine Picot, Denys Pierrejean, Lionel Piroth, Claire Plassart, Patrice Plessis, Marie-Cécile Ploy, Laurent Portel, Patrice Poubeau, Marie Poupard, Claire Poyart, Thierry Prazuck, Luc Quaesaet, François Raffi, Adriatsiferana Ramanantsoa, Christophe Rapp, Laurent Raskine, Josette Raymond, Matthieu Revest, Agnès Riche, Stéphanie Robaday-Voisin, Frédéric Robin, Jean-Pierre Romaszko, Florence Rousseau, Anne-Laure Roux, Cécile Royer, Matthieu Saada, Dominique Salmon, Carlo Saroufim, Jean Luc Schmit, Manuela Sebire, Christine Segonds, Valérie Sivadon-Tardy, Nathalie Soismier, Olivia Son, Simon Sunder, Florence Suy, Didier Tande, Jacques Tankovic, Nadia Valin, Nicolas Van Grunderbeeck, François Vandenesch, Emmanuelle Varon, Renaud Verdon, Michel Vergnaud, Véronique Vernet-Garnier, Magali Vidal, Virginie Vitrat, Daniel Vittecoq, Fanny Vuotto, Isabelle Gorenne, Cédric Laouenan, Pauline Manchon, Estelle Marcault, France Mentre, Blandine Pasquet, Carine Roy, Sarah Tubiana, Xavier Duval, Muhamed-Kheir Taha, Isabelle Lamaury, Lélia Escaut, Isabelle Gueit, Pauline Manchon, Sarah Tubiana, Bruno Hoen, COMBAT study group, Xavier Duval, Bruno Hoen, Bruno Mourvillier, Marie-Cécile Ploy, Sarah Tubiana, Emmanuelle Varon, François Caron, Pierre-Edouard Bollaert, Olivier Gaillot, Muhamed-Kheir Taha, Claire Poyart, Stephane Bonacorsi, François Vandenesch, Emmanuelle Cambau, Marc Lecuit, Alain Gravet, Bruno Frachet, Thomas De Broucker, Daniel Levy Bruhl, François Raffi, Marie Preau, Nadia Anguel, Laurent Argaud, Sophie Arista, Laurence Armand-Lefevre, Stéphanie Balavoine, Régine Baraduc, Guilène Barnaud, Guillaume Beraud, Louis Bernard, Georges Bernars, Dominique Bertei, Emilie Bessede, Typhaine Billard Pomares, Charlotte Biron, Stéphane Bland, Julien Boileau, Patrice Boubeau, Sandra Bourdon, Aurore Bousquet, Sophie Boyer, Alexis Bozorg-Grayeli, Laurent Bret, Cédric Bretonniere, François Bricaire, Elsa Brocas, Michel Brun, Jennifer Buret, Christophe Burucoa, Jean Cabalion, Mathieu Cabon, Emmanuelle Cambau, Guillaume Camuset, Christophe Canevet, François Caron, Anne Carricajo, Bernard Castan, Eric Caumes, Charles Cazanave, Amélie Chabrol, Thibaut Challan-Belval, Vanessa Chanteperdrix-Marillier, Chantal Chaplain, Caroline Charlier-Woerther, Hélène Chaussade, Catherine Chirouze, Bernard Clair, Julien Colot, Jean-Marie Conil, Hugues Cordel, Philippe Cormier, Joël Cousson, Pierrick Cronier, Eric Cua, Anne Dao-Dubremetz, Sylvie Dargere, Nicolas Degand, Sophie Dekeyser, Deborah Delaune, Eric Denes, Pierre-Francois Dequin, Diane Descamps, Elodie Descloux, Jean-Luc Desmaretz, Jean-Luc Diehl, Jérôme Dimet, Aurélien Dinh Xavier Duval, Lelia Escaut, Claude Fabe, Frédéric Faibis, Clara Flateau, Nathalie Fonsale, Emmanuel Forestier, Nicolas Fortineau, Amandine Gagneux-Brunon, Caroline Garandeau, Magali Garcia, Denis Garot, Stéphane Gaudry, François Goehringer, Alain Gravet, Valérie Gregoire-Faucher, Marine Grosset, Camélia Gubavu, Isabelle Gueit, Dominique Guelon, Thomas Guimard, Jérôme Guinard, Tahar Hadou, Jean-Pierre Helene, Sandrine Henard, Benoit Henry, Anne-Cécile Hochart, Bruno Hoen, Gabriela Illes, Sylvain Jaffuel, Irène Jarrin, Françoise Jaureguy, Cédric Joseph, Marie-Emmanuelle Juvin, Samer Kayal, Solen Kerneis, Flore Lacassin, Isabelle Lamaury, Philippe Lanotte, Etienne Laurens, Henri Laurichesse, Cécile Le Brun, Vincent Le Moing, Paul Le Turnier, Hervé Lecuyer, Sylvie Ledru, Céline Legrix, Adrien Lemaignen, Chantal Lemble, Ludovic Lemee, Olivier Lesens, Marion Levast, Claire Lhommet, Silvija Males, Edith Malpote, Guillaume Martin-Blondel, Matthieu Marx, Raphael Masson, Olivier Matray, Aurore Mbadi, Frédéric Mechai, Guillaume Mellon, Audrey Merens, Marie Caroline Meyohas, Adrien Michon, Joy Mootien Yoganaden, David Morquin, Stéphane Mouly, Natacha Mrozek, Sophie Nguyen, Yohan Nguyen, Maja Ogielska, Eric Oziol, Bernard Page, Solène Patrat-Delon, Isabelle Patry, André Pechinot, Sandrine Picot, Denys Pierrejean, Lionel Piroth, Claire Plassart, Patrice Plessis, Marie-Cécile Ploy, Laurent Portel, Patrice Poubeau, Marie Poupard, Claire Poyart, Thierry Prazuck, Luc Quaesaet, François Raffi, Adriatsiferana Ramanantsoa, Christophe Rapp, Laurent Raskine, Josette Raymond, Matthieu Revest, Agnès Riche, Stéphanie Robaday-Voisin, Frédéric Robin, Jean-Pierre Romaszko, Florence Rousseau, Anne-Laure Roux, Cécile Royer, Matthieu Saada, Dominique Salmon, Carlo Saroufim, Jean Luc Schmit, Manuela Sebire, Christine Segonds, Valérie Sivadon-Tardy, Nathalie Soismier, Olivia Son, Simon Sunder, Florence Suy, Didier Tande, Jacques Tankovic, Nadia Valin, Nicolas Van Grunderbeeck, François Vandenesch, Emmanuelle Varon, Renaud Verdon, Michel Vergnaud, Véronique Vernet-Garnier, Magali Vidal, Virginie Vitrat, Daniel Vittecoq, Fanny Vuotto, Isabelle Gorenne, Cédric Laouenan, Pauline Manchon, Estelle Marcault, France Mentre, Blandine Pasquet, Carine Roy, Sarah Tubiana

Abstract

Introduction: COMBAT is a prospective, multicentre cohort study that enrolled consecutive adults with community-acquired bacterial meningitis (CABM) in 69 participating centres in France between February 2013 and July 2015 and followed them for 1 year.

Methods: Patients aged at least 18 years old, hospitalised with CABM were followed during their hospitalisation and then contacted by phone 12 months after enrolment. Here we present the prevalence of sequelae at 12 months in a subgroup of patients with meningococcal meningitis.

Results: Five of the 111 patients with meningococcal meningitis died during initial hospitalisation and two died between discharge and 12 months, leaving 104 patients alive 1 year after enrolment, 71 of whom provided 12-month follow-up data. The median age was 30.0 years and 54.1% of the patients had no identified risk factor for meningitis. More than 30% reported persistent headache, more than 40% were not satisfied with their sleep and 10% had concentration difficulties. Hearing loss was present in about 15% of the patients and more than 30% had depressive symptoms. About 13% of the patients with a previous professional activity had not resumed work. On the SF-12 Health Survey, almost 50% and 30% had physical component or mental component scores lower than the 25th percentile of the score distribution in the French general population. There was a non-significant improvement in the patients' disability scores from hospital discharge to 12 months (p = 0.16), but about 10% of the patients had residual disability.

Conclusions: Although most patients in our cohort survive meningococcal meningitis, the long-term burden is substantial and therefore it is important to ensure a prolonged follow-up of survivors and to promote preventive strategies, including vaccination.

Trial registration: ClinicalTrial.Gov identification number NCT01730690.

Keywords: Community-acquired bacterial meningitis; France; Long-term follow-up; Meningococcal meningitis.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Study flow chart

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