Clinical Progress and Risk Factors for Death in Severe Fever with Thrombocytopenia Syndrome Patients
| Autor: | Na Zhou, Dexin Li, Shuo Zhang, Mifang Liang, Xiao-Ying Li, Zhong-Tao Gai, Bin Wang, Jin-Xia Liu, Anqiang Xu, Ying Zhang, Cong Jin, Xiu-Guang Song, Peng-Fei Bian, Zhenqiang Bi, Chuan Li, Shi-Jun Chen, Quanfu Zhang, Cheng-Bao Zhu, Li-Hua Zhang |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Phlebovirus medicine.medical_specialty Disease Bunyaviridae Infections Gastroenterology Risk Factors Internal medicine Case fatality rate medicine Humans Immunology and Allergy Aged Aged 80 and over Disseminated intravascular coagulation biology business.industry SFTS virus Middle Aged Viral Load medicine.disease biology.organism_classification Blood Cell Count Severe fever with thrombocytopenia syndrome Infectious Diseases Host-Pathogen Interactions Immunology biology.protein Female Partial Thromboplastin Time Creatine kinase business Viral load Biomarkers Severe fever with thrombocytopenia syndrome virus |
| Zdroj: | Journal of Infectious Diseases. 206:1095-1102 |
| ISSN: | 1537-6613 0022-1899 |
| Popis: | Background Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by the SFTS virus (SFTSV) with an average fatality rate of 12%. The clinical factors for death in SFTS patients remain unclear. Methods Clinical features and laboratory parameters were dynamically collected for 11 fatal and 48 non-fatal SFTS cases. Univariate logistic regression was used to evaluate the risk factors associated with death. Results Dynamic tracking of laboratory parameters revealed that during the initial fever stage, the viral load was comparable for the patients who survived as well as the ones that died. Then in the second stage when multi-organ dysfunction occurred, from 7-13 days after disease onset, the viral load decreased in survivors but it remained high in the patients that died. The key risk factors that contributed to patient death were elevated serum aspartate aminotransferase, lactate dehydrogenase, creatine kinase, and creatine kinase fraction, as well as the appearance of CNS (central nervous system) symptoms, hemorrhagic manifestation, disseminated intravascular coagulation, and multi-organ failure. All clinical markers reverted to normal in the convalescent stage for SFTS patients who survived. Conclusions We identified a period of 7-13 days after the onset of illness as the critical stage in SFTS progression. A sustained serum viral load may indicate that disease conditions will worsen and lead to death. |
| Databáze: | OpenAIRE |
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