Coagulopathy in Acute Puumala Hantavirus Infection

Hemorrhagic Fever with Renal Syndrome (HFRS) is the most frequently diagnosed zoonosis in Asia. This zoonotic infection is the result of exposure to the virus-contaminated aerosols. Orthohantavirus infection may cause Hemorrhagic Fever with Renal Syndrome (HRFS), a disease that is characterized by acute kidney injury and increased vascular permeability. Several species of orthohantaviruses were identified as causing infection, where Hantaan, Puumala, and Seoul viruses are most common. Orthohantaviruses are endemic to several Asian countries, such as China, South Korea, and Japan. Along with those countries, HFRS tops the list of zoonotic infections in the Far Eastern Federal District of Russia. Recently, orthohantavirus circulation was demonstrated in small mammals in Thailand and India, where orthohantavirus was not believed to be endemic. In this review, we summarized the current data on orthohantaviruses in Asia. We gave the synopsis of the history and diversity of orthohantaviruses in Asia. We also described the clinical presentation and current understanding of the pathogenesis of orthohantavirus infection. Additionally, conventional and novel approaches for preventing and treating orthohantavirus infection are discussed.

Section: Pathogenesis Of Orthohantavirus Infectionsmentioning

confidence: 99%

Hemorrhagic Fever with Renal Syndrome in Asia: History, Pathogenesis, Diagnosis, Treatment, and Prevention

Sehgal

Mehta

Sahay

et al. 2023

“…Many kinds of infections are known to be associated with increased risk for venous thrombosis [ 6 ]. There are many well-known interactions between hantavirus infection, inflammatory mediators, the endothelium, the complement system, and the coagulation system, which can be associated with this complication [ 7 ].…”

Section: Cardiovascular Systemmentioning

confidence: 99%

Long-Term Consequences of Puumala Hantavirus Infection

Mustonen

Vaheri

Pörsti

et al. 2022

Self Cite

Several viral infections are associated with acute and long-term complications. During the past two years, there have been many reports on post-infectious symptoms of the patients suffering from COVID-19 disease. Serious complications occasionally occur during the acute phase of Puumala orthohantavirus caused nephropathia epidemica. Severe long-term consequences are rare. Fatigue for several weeks is quite common. Hormonal insufficiencies should be excluded if the patient does not recover normally.

“…Plasma terminal complement complex SC5b-9 levels, in turn, correlate with severe thrombocytopenia in infection by PUUV [55]. Thus, PTX-3 is thought to have a role in the disease pathogenesis due to the cross-linkage of coagulation and complement system activation [9,56,57].…”

Section: Pentraxin-3mentioning

confidence: 99%

Severity Biomarkers in Puumala Hantavirus Infection

Outinen

Mäkelä

Pörsti

et al. 2021

Self Cite

Annually, over 10,000 cases of hemorrhagic fever with renal syndrome (HFRS) are diagnosed in Europe. Puumala hantavirus (PUUV) causes most of the European HFRS cases. PUUV causes usually a relatively mild disease, which is rarely fatal. However, the severity of the infection varies greatly, and factors affecting the severity are mostly unrevealed. Host genes are known to have an effect. The typical clinical features in PUUV infection include acute kidney injury, thrombocytopenia, and increased vascular permeability. The primary target of hantavirus is the endothelium of the vessels of different organs. Although PUUV does not cause direct cytopathology of the endothelial cells, remarkable changes in both the barrier function of the endothelium and the function of the infected endothelial cells occur. Host immune or inflammatory mechanisms are probably important in the development of the capillary leakage. Several immunoinflammatory biomarkers have been studied in the context of assessing the severity of HFRS caused by PUUV. Most of them are not used in clinical practice, but the increasing knowledge about the biomarkers has elucidated the pathogenesis of PUUV infection.