Severe fever with thrombocytopenia syndrome: a systematic review and meta-analysis of epidemiology, clinical signs, routine laboratory diagnosis, risk factors, and outcomes
| Autor: | Hongxia Ma, Wan-shen Guo, Yi Li, Bianli Xu, Bohao Wang, Zhiquan He, Xingle Li, Yanhua Du, Xueyong Huang |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
Phlebovirus 0301 basic medicine China medicine.medical_specialty Clinical signs Routine laboratory diagnosis Fever Epidemiology 030106 microbiology Outcomes Antibodies Viral Communicable Diseases Emerging lcsh:Infectious and parasitic diseases 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans lcsh:RC109-216 030212 general & internal medicine Risk factor Epidemics Aged Farmers SFTS business.industry Incidence Incidence (epidemiology) Leukopenia Syndrome Odds ratio Middle Aged medicine.disease Thrombocytopenia Confidence interval Meta-analysis Severe fever with thrombocytopenia syndrome Phlebotomus Fever Infectious Diseases Risk factors Vomiting RNA Viral Female medicine.symptom business Research Article |
| Zdroj: | BMC Infectious Diseases, Vol 20, Iss 1, Pp 1-12 (2020) BMC Infectious Diseases |
| ISSN: | 1471-2334 |
| DOI: | 10.1186/s12879-020-05303-0 |
| Popis: | Background Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease with the high case-fatality rate, and lack of vaccines. We aimed to systematically analysed the epidemiological characteristics, clinical signs, routine laboratory diagnosis, risk factors, and outcomes. Methods Documents on SFTS were collected by searching the Chinese National Knowledge Infrastructure, Wan Fang Data, PubMed, Embase, and Web of Science databases from 2011 to 2018. Meta-analysis was performed by using Review Manager and Stata software. Results Twenty-five articles involving 4143 cases were included. Diarrhea (odds ratio (OR) =1.60, 95% confidence interval (CI): 1.06 to 2.42, P = 0.02), and vomiting (OR = 1.56, 95% CI: 1.01 to 2.39, P = 0.04) on admission were associated with the fatal outcomes of SFTS. Compared to patients with mild symptoms, patients with severe symptoms had significantly elevated levels of lactic acid dehydrogenase (standard mean difference (SMD) =1.27, 95% CI: 0.59 to 1.94), alanine aminotransferase (SMD = 0.55, 95% CI: 0.24 to 0.85), aspirate aminotransferase (SMD = 1.01, 95% CI: 0.69 to 1.32), and creatine kinase (SMD = 1.04, 95% CI: 0.74 to 1.33) but had reduced platelet counts (SMD = -0.87, 95% CI: − 1.16 to − 0.58) and albumin levels (SMD = -1.00, 95% CI: − 1.32 to − 0.68). The risk factors for poor prognosis included age (mean difference (MD) =6.88, 95% CI: 5.41 to 8.35) and farming (OR = 2.01, 95% CI: 1.06 to 3.80). For the risk factors of contracting SFTS, the incidence of SFTS related to tick bites was 24% [95% CI: 0.18 to 0.31]. The pooled case-fatality rate of SFTS patients was 18% [95% CI: 0.16 to 0.21]. Conclusions China is the country with the highest incidence of SFTS. May to July was the peak of the epidemic, and farmers were a high-risk group. The risk factor for SFTS included age (poor prognosis) and tick bites (contracting SFTS). Patients with severe diarrhea and vomiting symptoms on admission should be noted. Clinicians could use routine laboratory parameters and clinical symptoms as references for clinically suspected cases, classification of SFTS, and timely treatment, especially in basic hospitals. |
| Databáze: | OpenAIRE |
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