The effectiveness of routine laboratory findings in determining disease severity in patients with Crimean-Congo hemorrhagic fever: Severity prediction criteria

Yılmaz, Gürdal; Köksal, İftihar; Topbaş, Murat; Yılmaz, Hülya; Aksoy, Firdevs

doi:10.1016/j.jcv.2010.01.010

Cited by 51 publications

(63 citation statements)

References 11 publications

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“…Physiopathology of this disease has been already studied in several studies [12,13,20]. To this date, many parameters have been suggested to evaluate the severity of the disease including decreased thrombocytopenia, prolonged PT and PTT, liver transaminases, muscular enzymes, cytokines such as IL-6 and IL-10 [8,24,25] …”

Section: Discussionmentioning

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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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: Discussionmentioning

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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“…The important factors related to mortality during the first five days of disease are mainly men-tioned as platelet count less than 20000/mm 3 , ALT ≥ 900 U/L, AST ≥ 700 U/L, PTT ≥ 60 sec, and fibrinogen count less than or equal to 110 mg/dL (10). In a study, it has been suggested the level of 1060 ng/dL ferritin serum (sensitivity of 78.9% and specificity of 87%) in order to differentiate between severe and non-severe cases based on the DIC index (11).…”

Section: Introductionmentioning

confidence: 99%

Viral Load as a Predictor of Severity in Crimean-Congo Hemorrhagic Fever

Metanat

Sharifi-Mood

Salehi

et al. 2016

Arch Clin Infect Dis

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“…Crimean-Congo hemorrhagic fever (CCHF) is spread by Crimean-Congo Hemorrhagic Fever Virus (CCHFV), a member of the genus Nairovirus of the family Bunyaviridae [Whitehouse, 2004;Yilmaz et al, 2010]. The disease is a potentially fatal viral infection in various parts of Africa, Asia, Eastern Europe, and the Middle East [Gunaydin et al, 2010].…”

Section: Introductionmentioning

confidence: 99%

“…More severe cases, however, may also present with epistaxis, hematemesis, melena, hematuria, gingival or vaginal bleeding, petechiae or ecchymosis [Whitehouse, 2004;Ergonul, 2006]. The most important component in the management of CCHF is supportive treatment, which includes intensive monitoring of volume of delivered platelets, fresh frozen plasma and erythrocyte preparations [Ozkurt et al, 2006;Yilmaz et al, 2010]. Although there has been a major effort to improve the management of CCHF, early diagnosis and evaluation of severity remains an important clinical problem.…”

Section: Introductionmentioning

confidence: 99%

“…Although there has been a major effort to improve the management of CCHF, early diagnosis and evaluation of severity remains an important clinical problem. Therefore, an early biochemical marker would be useful in helping to diagnose and evaluate the severity of CCHF and in determining the most appropriate management strategy [Whitehouse, 2004;Yilmaz et al, 2010]. A colorimetric assay was described to investigate the reduced cobalt binding capacity of albumin (IMA level) [Bar-Or et al, 2000].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Diagnostic and prognostic value of Ischemia‐modified albumin in patients with Crimean‐Congo hemorrhagic fever

Menteşe

Köksal

Sümer

et al. 2013

Journal of Medical Virology

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The aim of this study was to determine the diagnostic and prognostic significance of ischemia modified albumin (IMA) levels in patients with Crimean-Congo hemorrhagic fever (CCHF). This retrospective study was conducted with patients with CCHF. IMA levels in patients with CCHF were determined using the rapid colorimetric method. IMA levels of CCHF patients were significantly higher compared with the control group (P = 0.0001). At an IMA cut-off point of 0.555 ABSU (absorbance units), sensitivity was 65.1%, specificity 82.5%, positive predictive values (PPV) 82.5%, and negative predictive values (NPV) 65.1%. IMA levels of patients with hemorrhage were significantly higher compared with patients without hemorrhage (P = 0.005). IMA has been validated as both a new and sensitive ischemia and oxidative stress biomarker. In addition to its diagnostic significance, IMA investigated in CCHF patients at time of arrival may be an important marker with its prognostic role in determining in the early stage whether the disease will follow a hemorrhagic course.

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The effectiveness of routine laboratory findings in determining disease severity in patients with Crimean-Congo hemorrhagic fever: Severity prediction criteria

Cited by 51 publications

References 11 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?

Viral Load as a Predictor of Severity in Crimean-Congo Hemorrhagic Fever

Diagnostic and prognostic value of Ischemia‐modified albumin in patients with Crimean‐Congo hemorrhagic fever

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