Prognostic value and dynamic change characteristics of cytokines in Severe fever with thrombocytopenia syndrome

Abstract

Background: Severe fever with thrombocytopenia syndrome (SFTS) is a serious infectious disease that has received widespread attention. This study focuses on the predictive value and trend of cytokines in SFTS. Methods: Information of 128 SFTS patients retrospectively collected from January 2019 to January 2022 from a large general hospital in Anhui Province, China. Multivariate Cox model was used to identify predictors of death, ROC curve was used to calculate the value of predictors. Linear regression analysis was used to explore the correlation between cytokines and viral titers. Dynamic changes in cytokines to demonstrate therapeutic significance. Results: Of the 128 patients diagnosed with SFTS, 34 died during the course of the disease. Cytokines were significantly higher in the non-survival group than the survival group, while CD4 and CD8 counts were lower in the non-survival group. Multivariate Cox analysis showed that TNF-α was an independent predictor of death (p = 0.038, HR = 12.78) with an AUC value of 0.901. TNF-α, IL-6, IL-10 and IL-8 were correlated with viral titer (p < 0.001, 0.5 < r < 1). Different cytokines showed different trends in the course of treatment. High dose gamma-globulin shock therapy combined with ribavirin can effectively reduce the level of some cytokines (IL-6, IL-2R, IL-10). Conclusion: TNF-α is an independent predictor of SFTS death outcome and has excellent predictive value. There was a significant correlation between TNF-α, IL-6, IL-10, IL-8 and virus titer. Gamma-globulin shock therapy combined with ribavirin can control cytokine storm to some extent and provide new ideas for clinical treatment.