Coagulopathy parameters in patients with Crimean‐Congo hemorrhagic fever and its relation with mortality

Öngürü, Pınar; Dağdaş, Simten; Bodur, Hürrem; Yılmaz, Mesude; Akıncı, Esragül; Eren, Selim Sırrı; Özet, Gülsüm

doi:10.1002/jcla.20383

Cited by 42 publications

(38 citation statements)

References 16 publications

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Section: Introductionmentioning

confidence: 94%

“…One study reported higher mortality rate to be associated with: platelet count lower than 20,000/mm 3 , PTT longer than 60 seconds [9]. Coagulopathy parameters (thrombocytopenia, prolonged PT, PTT, INR and d-dimer level )and their correlation with disease severity in CCHF have been suggested in another study [9]. Another study designed to evaluate criteria predicting the disease severity reported the lab parameters indicating disease severity: platelet count<20000/mm 3 , and decrease of levels of hematocrit and fibrinogen, elevation of creatine phosphokinase titer and lactate dehydrogenase, aspartate aminotransferase, alanine aminotransferase, prothrombin time (PT) and partial thromboplastin time (PTT) , developing melena and loss of consciousness [10].…”

Section: Introductionmentioning

confidence: 99%

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Can Serum Ferritin Level Predict Disease Severity in Patients with Crimean-Congo Hemorrhagic Fever?

Metanat

Sharifi-Mood

Tabatabaei

et al. 2013

EAJM

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Objective: Crimean-Congo hemorrhagic fever (CCHF) is an acute viral disease. Several factors have already been suggested to explain the pathogenesis as well as predict the disease severity. In our study we aim to investigate the role of serum ferritin level as a possible predicting factor of disease severity in these patients. Materials and Methods:We evaluated all patients with laboratory confirmed diagnosis of CCHF who were admitted to Boo-Ali Hospital of Zahedan from May 2011 to June 2012. Confirmation of the disease determined using the presence of anti-CCHFV IgM in the serum by enzyme-linked immunosorbent assay (ELISA) or by polymerase chain reaction(PCR). After ethical approval, patients were categorized into two groups of mild and severe disease according to disseminated intravascular coagulation (DIC) severity using the scoring system of International Society on Thrombosis and Hemostasis (ISTH) . Serum ferritin levels were evaluated and compared between these two groups. Receiver operating characteristic (ROC) curve analysis was performed to assess the optimal cutoff value of serum ferritin for predicting the disease severity.Results: A total of 42 patients (36 men, 6 women, age range: 17-78 years) were included in this study, of whom 38% had Persian and 62% had Baloch ethnicity. According to DIC severity score, 54.7% of the patients had severe disease and 45.3% had mild disease. The area under the ROC curve was 0.896 and 95% CI was 0.801-0.991 (p<0.0001). A cut-off point of 1060 ng/dL, had a sensitivity of 78.9%, a specificity of 87%, a positive predictive value of 6% and a negative predictive value of 100%. Positive and negative likelihood ratios for this serum ferritin level were 6.05 and 0.24, respectively. Conclusion:Increased serum ferritin level has a significant positive correlation with disease severity in patients with CCHF and can evaluate the prognosis of these patients with a high sensitivity and specificity.Key Words: Crimean-Congo hemorrhagic fever, disease severity, ferritin Bulgular:Toplam 42 hasta (36 erkek, 6 kadın, yaş aralığı: 17-78 yıl olmak üzere) bu çalışmaya dahil edilmiştir, hastaların %38 Pers ve %62 Baloch etnik grubuna dahildir. DIC şiddet skoruna göre, hastaların %54.7 ciddi ve %45.3 'ü hafif olarak sınıflandırılmıştır. ROC eğrisi altında kalan alan 0.896 ve %95 CI 0.801-0.991 (p değeri <0.05) bulunmuştur. 1.060 ng/dL bir kesim noktası %78.9 bir duyarlılık, %87 özgüllük, %6 bir pozitif prediktif değer ve %100 bir negatif prediktif değer tespit edilmiştir. Bu serum ferritin düzeyi için pozitif ve negative olabilirlik oranları sırasıyla 6.05 ve 0.24 olarak bulunmuştur.Sonuç: Artmış serum ferritin düzeyi KKKA hastalarında hastalık şid-deti ile anlamlı pozitif korelasyona sahiptir ve bu hastalarda prognozu yüksek bir duyarlılık ve özgüllük ile gösterebilir.

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Section: Introductionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Can Serum Ferritin Level Predict Disease Severity in Patients with Crimean-Congo Hemorrhagic Fever?

Metanat

Sharifi-Mood

Tabatabaei

et al. 2013

EAJM

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“…Experience over the past decade in Turkey has shown that gingival bleeding, ecchymoses, hematemesis, diarrhea, melena, confusion and somnolence are significantly more common in fatal cases (Ergonul et al, 2006a;Cevik et al, 2008;Hatipoglu et al, 2010). Lethal illness was associated with more severe thrombocytopenia, more prolonged PT and aPTT, lower fibrinogen levels and increased serum AST and ALT (Ergonul et al, 2006a;Ozkurt et al, 2006;Onguru et al, 2010). Serum levels of neopterin, a derivative of GTP released by activated macrophages, were higher in fatal than nonfatal cases of CCHF (Onguru et al, 2008).…”

Section: Predictors Of Survival or Deathmentioning

confidence: 99%

Crimean-Congo hemorrhagic fever: History, epidemiology, pathogenesis, clinical syndrome and genetic diversity

et al. 2013

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Bente, Dennis A.; Forrester, Naomi L.; Watts, Douglas M.; McAuley, Alexander J.; Whitehouse, Chris A.; and Bray, Mike, "CrimeanCongo hemorrhagic fever: History, epidemiology, pathogenesis, clinical syndrome and genetic diversity" (2013 b s t r a c tCrimean-Congo hemorrhagic fever (CCHF) is the most important tick-borne viral disease of humans, causing sporadic cases or outbreaks of severe illness across a huge geographic area, from western China to the Middle East and southeastern Europe and throughout most of Africa. CCHFV is maintained in vertical and horizontal transmission cycles involving ixodid ticks and a variety of wild and domestic vertebrates, which do not show signs of illness. The virus circulates in a number of tick genera, but Hyalomma ticks are the principal source of human infection, probably because both immature and adult forms actively seek hosts for the blood meals required at each stage of maturation. CCHF occurs most frequently among agricultural workers following the bite of an infected tick, and to a lesser extent among slaughterhouse workers exposed to the blood and tissues of infected livestock and medical personnel through contact with the body fluids of infected patients. CCHFV is the most genetically diverse of the arboviruses, with nucleotide sequence differences among isolates ranging from 20% for the viral S segment to 31% for the M segment. Viruses with diverse sequences can be found within the same geographic area, while closely related viruses have been isolated in far distant regions, suggesting that widespread dispersion of CCHFV has occurred at times in the past, possibly by ticks carried on migratory birds or through the international livestock trade. Reassortment among genome segments during co-infection of ticks or vertebrates appears to have played an important role in generating diversity, and represents a potential future source of novel viruses. In this article, we first review current knowledge of CCHFV, summarizing its molecular biology, maintenance and transmission, epidemiology and geographic range. We also include an extensive discussion of CCHFV genetic diversity, including maps of the range of the virus with superimposed phylogenetic trees. We then review the features of CCHF, including the clinical syndrome, diagnosis, treatment, pathogenesis, vaccine development and laboratory animal models of CCHF. The paper ends with a discussion of the possible future geographic range of the virus. For the benefit of researchers, we include a Supplementary Table listing all published reports of CCHF cases and outbreaks in the English-language literature, plus some principal articles in other languages, with total case numbers, case fatality rates and all CCHFV strains on GenBank.

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“…6 Currently, more than 600 antigenic structures among 29 blood groups have been described in humans. 7 The relationship between CCHF and certain blood groups identified as significant for a number of diseases is not clear. 8 In this trial, apart from well-known indicators of poor prognosis, we aimed to investigate the association of blood group with mortality and its relationship to prognosis in CCHF, an acute and potentially fatal disease with no definite treatment.…”

Section: J Microbiol Infect Dis Wwwjcmidorg Vol 1 No 3 December 2011mentioning

confidence: 99%

Is blood group associated with mortality in Crimean-Congo Hemorrhagic Fever?

Duygu¹

2011

JMID

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Objectives: In this trial, our purpose was to determine the distribution of blood groups in Tokat region and CrimeanCongo hemorrhagic fever (CCHF) patient group and to investigate the impact of blood groups on fatal prognosis of the disease. Material and Method:Demographic and laboratory values and blood groups of patients were recorded. In addition, distribution of blood groups among blood donors who referred to the blood center during same time interval was determined.Results: Distribution of blood groups among CCHF patients and donors in blood center were found to be similar to Turkish data (P>0.05). On the other hand, a discrepancy was determined in blood group distribution of CCHF patients with a fatal outcome, with a significantly high rate of AB Rh negative blood group in this patient group (P<0.001). Conclusion:We suggest that blood group may be associated with mortality in CCHF patients and AB Rh negative blood group may be an indicator of poor prognosis. J Microbiol Infect Dis 2011;1(3):118-121

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Coagulopathy parameters in patients with Crimean‐Congo hemorrhagic fever and its relation with mortality

Abstract: Laboratory tests including classical parameters (platelet count, PT, aPTT, INR, and fibrinogen) of coagulopathy seem to be enough for the followup of CCHF. Protein S, protein C, APCR, and D-dimer levels were not associated with mortality.

Cited by 42 publications

References 16 publications

Can Serum Ferritin Level Predict Disease Severity in Patients with Crimean-Congo Hemorrhagic Fever?

Can Serum Ferritin Level Predict Disease Severity in Patients with Crimean-Congo Hemorrhagic Fever?

Crimean-Congo hemorrhagic fever: History, epidemiology, pathogenesis, clinical syndrome and genetic diversity

Is blood group associated with mortality in Crimean-Congo Hemorrhagic Fever?

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