Clinical severity in forecasting platelet to lymphocyte ratio in Crimean–Congo hemorrhagic fever patients

Abstract

Crimean-Congo hemorrhagic fever (CCHF) is a life-threatening disease that develops as a result of infection by a member of the Nairovirus genus of the Bunyaviridae family, and its initial symptoms are not specific. In patients with severe clinical progression, in particular, the neutrophil rate is high, whereas lymphocyte and monocyte levels are low. A total of 149 patients, in whom the diagnosis was confirmed with reverse transcriptase PCR, were included in the study. In order to compare patient clinical progression severity, we divided the patients into two groups. For group 1, Çevik's severity score was used. The patients who had a platelet/lymphocyte ratio (PLR) <41 constituted group 2. Of 149 patients, 20 (13.4 %) were determined as group 1 (Çevik's classification) and 38 (25.5 %) were determined as group 2 (PLR <41). Of 11 deaths, 4 (36.4 %) patients were from group 1 and 7 (63.6 %) were from group 2. This is the first study to our knowledge to analyse the relationship between severity and PLR in patients with CCHF. PLR is a simple laboratory test that can aid in determining the prognosis of individuals with this disease.

Fluorescent Crimean-Congo hemorrhagic fever virus illuminates tissue tropism patterns and identifies early mononuclear phagocytic cell targets in Ifnar-/- mice

“…Increased levels of murine CXCL1 and CXCL2, functional homologs of human IL-8, correlate with reports of IL-8 as a diagnostic marker for disease severity in humans [52]. Finally, changes in clinical chemistry and CBC values reported in humans as important diagnostic markers for predicting disease severity, including elevated AST and ALT, elevated neutrophils, and lymphopenia [1,17,53,54], were also seen in Ifnar -/mice as disease severity increased.…”

“…Parallels to human disease seen in early-stage disease mice include: increased viral load; increased NK and activated macrophages cell numbers [19]; and increased levels of IL-10, IL-6, IFN-γ, CCL2, CCL5, and TNF-α [22,50,59] (also seen in late stage). Parallels seen in late-stage disease mice include: high viral loads (RNAemia) [60], elevated AST and ALT [61], elevated neutrophils [54], lymphopenia [1], and increases in IL-10, IL-6, IFN-γ, CCL2, CCL5, and TNF-α [22,50,59]. Identifying objective criteria to correlate disease course in mice to humans will allow improved translation of clinical and immunological indices (chemistry, biomarkers, celland antibody-mediated responses).…”

Serum PLR and LMR in Behçet's disease

“…Recently, increased PLR and decreased LMR have been reported to be associated with disease activity in many diseases. [ 33 – 37 ] But they could not show these correlations with other inflammatory marks such as hs-CRP or ESR. These serum inflammatory parameters can be considered as appropriate, confirmatory tests for hs-CRP and ESR.…”

The utility of peripheral blood leucocyte ratios as biomarkers in infectious diseases: A systematic review and meta-analysis

“…The PLR was evaluated in a cohort of 149 patients in Turkey with PCR-confirmed CCHF with an overall mortality of 7%. 28 Patients with PLR < 41 ( n = 38) were more likely to require transfusion of blood products (25/38 vs 33/111, p < 0.001) and had higher mortality (7/38 vs. 4/111, p < 0.001). Use of previously reported independent predictors of mortality (thrombocytopenia, prolonged APTT, melaena and somnolence 29 ) also performed well in identifying patients at risk of mortality, though the two were not compared directly.…”