Analysis of the laboratory indexes and risk factors in 189 cases of severe fever with thrombocytopenia syndrome

Abstract

The current study aimed to analyze the clinical characteristics of severe fever with thrombocytopenia syndrome (SFTS) and to explore the risk factors of critical patients. From 2016 to 2018, we collected the hospitalized diagnosed cases with SFTS in Jinan infectious disease hospital of Shandong University and analyzed by the descriptive epidemiological method. According to the prognosis, they were divided into general group and severe group. The epidemiological characteristics, clinical features, and laboratory indexes of these 2 groups of patients were compared and analyzed at the first visit. The risk factors related to the severity of the disease were analyzed by univariate Logistic regression. In total, 189 cases of SFTS were treated during the period and 33 deaths occurred in the severe group, with the fatality rate of 17.46%. The patients’ age (χ2 = 8.864, P < .01), ALT (Z = −2.304, P = .03), AST (Z = −3.361, P < .01), GLU (t = −4.115, P < .01), CK (Z = −3.964, P < .01), CK-MB (Z = −2.225, P = .03), LDH (Z = −3.655, P < .01), α-HBDH (Z = −2.040, P = .04), APTT (t = −3.355, P < .01), BUN (Z = −2.040, P = .04), Cr (Z = −3.071, P = .01), and D-dimer (Z = −2.026, P = .04) in the severe group were higher than that in the normal group, but the blood platelet (PLT) counts were significantly lower (Z = −2.778, P < .01) than that in the normal group. With the neuropsychiatric symptoms (OR = 24.083, 95% CI = 6.064–95.642), skin bleeding point (OR = 30.000, 95% CI = 6.936–129.764), multiple organ dysfunction (OR = 34.048, 95% CI = 7.740–149.782), past medical history (OR = 3.792, 95% CI = 1.284–11.200), and fasting glucose elevation (OR = 1.359, 95% CI = 1.106–1.668) could predict the severity of the SFTS. In summary, the abnormality of the laboratory index, the special clinical manifestations, and the past medical history of SFTS patients were the important basis for judging the patient's serious condition.

Comparison of Clinical Features and Prognosis of Severe Fever With Thrombocytopenia Syndrome Transmitted From Tick-to-person Versus Person-to-person

“…Huang et al [19] demonstrated the potential existence of infective virus particles in the mucosa and secretions of patients who may cause asymptomatic infection. The majority of the tickto-person transmission infection group were elderly farmers, a nding similar to many other studies [20].…”

Risk Factors of Neurological Complications in Severe Fever Patients with Thrombolytic Syndrome: A Single-Center Retrospective Study in China

“…In the present study, the LDH of patients with neurological complications reached the peak at the multiple organ dysfunction period and return to normal at decubation, while the difference in LDH in the other group was mild ( Figure 2 ). Similar differences can be seen in levels CK, AST, ALP, and GGT ( Figure 3 ), and all of these indicators are risk factors associated with the severity of SFTS [ 30 ]. Contrarily, we found that CRP, which is commonly seen in acute infections or trauma, increased gradually and reached a peak at decubation in the neurologic complications group ( Figure 2 ).…”

Corticosteroids May Have Negative Effects on the Management of Patients with Severe Fever with Thrombocytopenia Syndrome: A Case–Control Study

“…To identify poor prognostic factors, the baseline clinical and laboratory parameters, treatment, and outcomes, including complications of secondary infections, were compared between the fatal and nonfatal groups. The previously reported poor prognostic factors [ 4 , 5 , 6 , 8 , 9 ] were compared between the CS-treated and non-CS-treated groups. The propensity score (PS) was estimated to predict the probability of receiving CS treatment in each patient, using the following key variables: age, mental status changes, and levels of platelet, blood urea nitrogen (BUN), and prothrombin time-international normalized ratio (PT-INR).…”

“…The poor prognostic backgrounds for SFTS include advanced age, male sex [ 6 ], and underlying diseases, such as malignancies, diabetes mellitus, chronic viral hepatitis, and chronic obstructive pulmonary disease [ 5 , 7 ]. In addition, patients with central nervous system manifestations [ 4 , 8 ], high levels of alanine aminotransferase (ALT), lactate dehydrogenase (LDH), and creatine kinase (CK) [ 8 ], renal dysfunction [ 9 ], coagulopathy, high level viremia, and hypercytokinemia were reported to show poor prognosis [ 10 ]. To date, no standardized treatment protocol for SFTS has been established.…”