Clinical Features and Factors Associated with Disease Severity in Acute Chikungunya Fever: A Retrospective Analysis

Background: Chikungunya fever has emerged as a significant public health concern in tropical and subtropical regions worldwide. Understanding the epidemiological patterns and clinical features of chikungunya virus infection is crucial for developing effective disease surveillance and management strategies. Methods: We conducted a retrospective analysis of 311 laboratory-confirmed chikungunya fever cases presenting to a tertiary hospital in Foshan, Guangdong Province, China, from June to September 2025. Results: The study population had a median age of 32.35 years (interquartile range: 10-53 years), with females comprising 56.3%. Fever occurred in 85.9% of patients, with 49.2% experiencing moderate to high-grade fever. Joint symptoms were present in 76.5% of patients, with 48.6% developing moderate to severe arthralgia. Rash was a significant clinical manifestation with an incidence of 73%, of which 44.1% of patients presented with severe rash. Laboratory abnormalities included leukopenia (6.4%), lymphopenia (64.6%), and elevated C-reactive protein (66.2%). Multivariate analysis identified rash presence, joint symptoms, and younger age as factors significantly associated with moderate-severe disease presentations. However, as rash and joint symptom severity were incorporated into the severity scoring system, these associations should be interpreted as descriptive characterization rather than independent prediction. Conclusion: This study characterizes the clinical features of acute chikungunya fever, with age-related severity differences and specific clinical and laboratory markers associated with disease severity. Rash emerges as a significant clinical manifestation associated with disease severity, highlighting its value in clinical assessment of chikungunya fever. These findings support the development of risk stratification tools and evidence-based management protocols for chikungunya fever patients.