Crimean–Congo hemorrhagic fever (CCHF), whose causative agent is CCHF orthonairovirus (CCHFV), demonstrates different symptoms in patients. Long noncoding RNAs (lncRNAs) take part in various pathological processes of viral diseases. They are prominent regulators of antiviral immune responses. To our knowledge, this study is the first study to investigate nuclear paraspeckle assembly transcript 1 (NEAT1), interferon (IFN) gamma antisense RNA 1 (IFNG‐AS1), and negative regulator of IFN response (NRIR) expression in CCHF in the literature. We selected these lncRNAs because they are related to IFN signal or IFN‐stimulated genes. We investigated NEAT1, IFNG‐AS1, and NRIR gene expression in patients with CCHF. Total RNA was extracted from blood samples of 100 volunteers and NEAT1, IFNG‐AS1, and NRIR expression were measured using a quantitative real‐time polymerase chain reaction. NRIR expression was statistically significant in cases versus controls (p < .001), fatals versus controls (p < .001), and fatals versus nonfatals (p = .01). Furthermore, NRIR was found statistically significant at some clinical parameters including alanine aminotransferase (p = .03), international normalized ratio (p = .03), prothrombin time (p = .02), and active partial thromboplastin time (p = .01) in CCHF cases. NEAT1 and IFNG‐AS1 expression were downregulated in the case and fatal groups which were compared with controls. Our results demonstrate that NRIR may be important in CCHF pathogenesis and the target of CCHF treatment.

Crimean–Congo hemorrhagic fever (CCHF) is an emerging acute viral infection disease, yet its pathophysiology remains largely uncharacterized. Lipid mediators are molecules that play numerous roles in the physiologic and pathophysiologic conditions in certain viral diseases. No previous study evaluated the status of cysteinyl leukotrienes (CYSLT) and 5‐lipoxygenase (5‐LO) and their relationship with proinflammatory cytokines in CCHF. A total of 90 subjects including 60 CCHF patients and 30 healthy controls were enrolled the study. Serum CYSLT, 5‐LO, interleukin‐6 (IL‐6), and ferritin levels were determined in the study population. Lower median 5‐LO level was determined in patients compared to healthy controls (p = 0.0004). Higher ferritin (p < 0.001) and IL‐6 (p < 0.001) levels in patients than healthy controls. No statistically significant difference was observed between patients and controls in terms of CYSLT levels. No statistically significant differences were observed between mild, moderate, and severe groups in terms of both 5‐LO and CYSLT levels. IL‐6 and ferritin levels were higher in severe group compared mild and moderate groups. In conclusion, changes in 5‐LO enzyme and increased inflammation are related with the disease molecular mechanism. Higher inflammatory status contributes to the impaired hemostatic balance in CCHF. Thus, treatment strategies to reduce inflammation may help to prevent bleeding and DIC in patients. IL‐6 and ferritin can be used to as an additional biomarker in the estmation of the prognosis and diagnosis of the patients.

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In this study, we examined comparison of the predictive performance of quick sequential organ failure assessment (qSOFA), acute physiology and chronic health evaluation (APACHE 2) scores and severity grading score (SGS) for evaluation of the disease prognosis of Crimean-Congo hemorrhagic fever (CCHF) patients at the Emergency Department. We recorded qSOFA, SGS, and APACHE II scores at admission, and at 72nd and at 120th in 97 patients admitted to the emergency department and diagnosed with CCHF. In our study, Area Under The Curve (AUC) Receiver Operating Characteristic (ROC) values of qSOFA, SGS, and APACHE II at admission were found as 0.640, 0.824, and 0.576. No statistical significance was found for a qSOFA score ≥ 2 at admission as a predictor of mortality. The use of qSOFA score for diseases with a mortal prognosis such as CCHF is insufficient in predicting the prognosis.