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Sun Y, Zhang D, Liu H, Ruan C, Dou X, Ren Z, Ge Z, Du Z, Jin H, Li D, Xue H, Liu W, Chen Z, Wang Q. The first reported cases of severe fever with thrombocytopenia syndrome virus from domestic sick camel to humans in China. Emerg Microbes Infect 2024; 13:2309990. [PMID: 38269573 PMCID: PMC10860415 DOI: 10.1080/22221751.2024.2309990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 01/19/2024] [Indexed: 01/26/2024]
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne disease with an increasing annual incidence rate. In this case report, we presented two patients infected with the SFTS virus, suggesting a potential direct transmission route from camels to humans through blood contact. Both patients developed symptoms after engaging in the slaughtering of one sick camel, while their family members living in the same environment or co-diners remained unaffected. Subsequent detection revealed a high viral load of SFTS virus, reaching 1010 viral RNA copies/ml, in the sample obtained from the sick camel. Metagenomic sequencing did not identify any other pathogens. The SFTS virus was successfully isolated from both patient and camel samples. The complete nucleotide sequences obtained from the infected patients demonstrated a remarkable 100% similarity to those found in the camel, and genetic evolution analysis classified the virus as genotype A. Additionally, partial sequences of the SFTS virus were identified in ticks captured from the camel rearing environment, however, these sequences showed only 95.9% similarity to those found in camel and humans. Furthermore, immunoglobulin M and immunoglobulin G antibodies were detected in serum samples collected from the patient. Our findings provide evidence that camel may serve as a competent reservoir for transmitting the SFTS virus to humans. Further in vitro investigations into SFTS virus infections in large animals are warranted to understand their role in viral maintenance and transmission.
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Affiliation(s)
- Yulan Sun
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, People’s Republic of China
| | - Daitao Zhang
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, People’s Republic of China
| | - Hui Liu
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Chunlai Ruan
- Beijing Pinggu District Center for Disease Prevention and Control, Beijing, People’s Republic of China
| | - Xiangfeng Dou
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, People’s Republic of China
| | - Zhenyong Ren
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, People’s Republic of China
| | - Ziruo Ge
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Zhizhong Du
- Beijing Pinggu District Center for Disease Prevention and Control, Beijing, People’s Republic of China
| | - Haoyuan Jin
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, People’s Republic of China
| | - Dan Li
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, People’s Republic of China
| | - Hui Xue
- Beijing Pinggu District Center for Disease Prevention and Control, Beijing, People’s Republic of China
| | - Wei Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People’s Republic of China
| | - Zhihai Chen
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Quanyi Wang
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, People’s Republic of China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, People’s Republic of China
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Zhang S, Zhang Q, Wang J, Pan Y, Zhang Z, Geng Y, Jia B, Tian B, Xiong Y, Yan X, Li J, Wang H, Huang R, Wu C. Red Blood Cell Distribution Width Predicts Mortality in Hospitalized Patients with Severe Fever with Thrombocytopenia Syndrome. J Inflamm Res 2024; 17:4895-4904. [PMID: 39070134 PMCID: PMC11277826 DOI: 10.2147/jir.s468388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 07/11/2024] [Indexed: 07/30/2024] Open
Abstract
Background Severe fever with thrombocytopenia syndrome (SFTS) is an emerging epidemic infectious disease with high mortality rate. This study aimed to investigate the association of red blood cell distribution width (RDW) and mortality risk in hospitalized SFTS patients. Methods Clinical data of SFTS patients was retrospectively collected from three hospitals between October 2010 and August 2022. Cox proportional hazards model was used to identity the risk factors for fatal outcome. The predictive value of RDW for fatal outcome was evaluated by the receiver operating characteristic (ROC) analysis and Kaplan-Meier methods. Results Of 292 patients, the median age was 61.5 years. Non-survivors showed higher RDW value than survivors (13.6% vs.13.0%, P < 0.001). The mortality rate was 44.8% in patients with elevated RDW compared to 18.4% of patients with normal RDW, with a relative risk (RR) of 2.439. Elevated RDW was an independent risk factor of mortality (hazards ratio: 1.167, P = 0.019). Patients with elevated RDW had a higher cumulative mortality than patients with normal RDW. The area under the ROC curve (AUC) of RDW for the prediction of mortality was 0.690 (P < 0.001). Conclusion Elevated RDW was associated with higher mortality risk for patients hospitalized for SFTS. RDW may be helpful for risk stratification in SFTS patients.
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Affiliation(s)
- Shaoqiu Zhang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, People’s Republic of China
| | - Qun Zhang
- Department of Infectious Diseases, Affiliated Zhongda Hospital of Southeast University, Nanjing, Jiangsu, People’s Republic of China
| | - Jian Wang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, People’s Republic of China
- Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, People’s Republic of China
| | - Yifan Pan
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Zhiyi Zhang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People’s Republic of China
| | - Yu Geng
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, People’s Republic of China
| | - Bei Jia
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, People’s Republic of China
| | - Bing Tian
- Department of Infectious Diseases, Affiliated Zhongda Hospital of Southeast University, Nanjing, Jiangsu, People’s Republic of China
| | - Yali Xiong
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, People’s Republic of China
| | - Xiaomin Yan
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, People’s Republic of China
| | - Jie Li
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, People’s Republic of China
- Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, People’s Republic of China
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People’s Republic of China
| | - Huali Wang
- Department of General Practice, Nanjing Second Hospital, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People’s Republic of China
| | - Rui Huang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, People’s Republic of China
- Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, People’s Republic of China
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People’s Republic of China
| | - Chao Wu
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, People’s Republic of China
- Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, People’s Republic of China
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People’s Republic of China
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Cao K, Ma A, Zhang K, Zhang Y, Xiang X, Xu C, Han B, Xu Y, Tang L. Blood Urea Nitrogen-to-Serum Albumin Ratio Predicts Fatal Outcomes in Severe Fever with Thrombocytopenia Syndrome Patients. Am J Trop Med Hyg 2024; 111:113-120. [PMID: 38806039 PMCID: PMC11229660 DOI: 10.4269/ajtmh.23-0811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 03/11/2024] [Indexed: 05/30/2024] Open
Abstract
There are no effective therapies for severe fever with thrombocytopenia syndrome (SFTS), and existing predictors of mortality are still controversial. This retrospective study aimed to identify reliable early-stage indicators for predicting fatal outcomes in 217 patients hospitalized with an SFTS diagnosis between March 2021 and November 2023; 157 of the patients survived, and 60 died. Demographics, clinical characteristics, and laboratory parameters were reassessed in both groups. The mean age of participants was 64.0 (interquartile range: 54.5-71.0) years, and 42.4% (92/217) were males. Based on a multivariate Cox regression analysis, the blood urea nitrogen-to-serum albumin ratio (BAR) (hazard ratio [HR]:4.751; 95% CI: 2.208-10.226; P <0.001), procalcitonin level (HR: 1.946; 95% CI: 1.080-3.507; P = 0.027), and central nervous system symptoms (HR: 3.257; 95% CI, 1.628-6.513; P = 0.001) were independent risk factors for mortality in SFTS patients. According to a receiver operating characteristic curve analysis, a BAR with an area under the curve of 0.913 (95% CI: 0.873-0.953; P <0.001), a sensitivity of 76.7%, and a specificity of 90.4% showed better predictive performance for fatal outcomes than other classical indicators reported. The Kaplan-Meier survival curve confirmed that an increased BAR was linked with an unfavorable prognosis in SFTS patients (P <0.001 by log-rank test). In conclusion, the results indicate that high BAR levels are markedly related to substandard outcomes and are a reliable and readily accessible predictor of fatal outcomes in SFTS patients.
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Affiliation(s)
- Kangli Cao
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Along Ma
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ke Zhang
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yuntao Zhang
- The First Clinical Medical School of Anhui Medical University, Hefei, China
| | - Xinjian Xiang
- Department of Plastic and Reconstructive Surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Cairui Xu
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Binhang Han
- The First Clinical Medical School of Anhui Medical University, Hefei, China
| | - Yuanhong Xu
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ling Tang
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, China
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Peng W, Li J, Yu H, Zhou W, Lin L, Ge Z, Lai J, Chen Z, Zhu L, Zhao Z, Shen Y, Jin R, Duan J, Zhang W. Activated partial thromboplastin time predicts mortality in patients with severe fever with thrombocytopenia syndrome: A multicenter study in north China. Heliyon 2024; 10:e31289. [PMID: 38867977 PMCID: PMC11167268 DOI: 10.1016/j.heliyon.2024.e31289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 06/14/2024] Open
Abstract
Background Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease with high lethality. This study aimed to determine whether prolonged activated partial thromboplastin time (APTT) predicted SFTS mortality. Methods SFTS patients were enrolled from 6 hospitals in the north China. Subjects were divided into training cohort and 5 externally validation cohorts. The least absolute shrinkage and selection operator Cox regression model was performed to screen potential prognostic factors. Risk factors were analyzed using multivariable regression models. Prognostic models were established by Cox regression and random survival forest (RSF) methods, and evaluated regarding discrimination, validity and clinical benefit. Time-dependent receiver operating characteristic (ROC) curve was used to evaluate the predictive effectiveness of variables. Results 1332 SFTS cases were included, in which 211 patients died. Six potential prognostic factors were screened, and pulse, breath, APTT and aspartic transaminase (AST) were independently associated with mortality in both training cohort (Yantai, N = 791) and external validation cohort (N = 541). APTT was steadily correlated with the fatality (HR: 1.039-1.144; all P < 0.01) in each five sub-validation cohorts (Dandong, Dalian, Tai'an, Qingdao and Beijing). RSF model with variables of APTT, AST, pulse and breath had considerable prognostic effectiveness, which APTT showed the highest prognostic ability with the area under the curve of 0.848 and 0.787 for 7-day and 14-day survival, respectively. Survival differences were found between high and low levels of APTT for mortality using 50s as the optimal cut-off. Conclusions SFTS patients have prolonged APTT, which is an independent risk factor for fatality. APTT≥50s was recommended as a biomarker to remind physicians to monitor and treat patients more aggressively to improve clinical prognosis.
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Affiliation(s)
- Wenjuan Peng
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Infectious Diseases, Beijing, China
| | - Junnan Li
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Infectious Diseases, Beijing, China
| | - Hong Yu
- Department of Infectious Disease, Yantai City Hospital for Infectious Disease, Yantai, China
| | - Wei Zhou
- Department of Public Health Clinical Center, Dalian, China
| | - Ling Lin
- Department of Infectious Disease, Yantai City Hospital for Infectious Disease, Yantai, China
| | - Ziruo Ge
- Center of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Jianming Lai
- Department of Infectious Disease, Qing Dao No 6 People's Hospital, Qingdao, China
| | - Zhihai Chen
- Center of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Liuluan Zhu
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Infectious Diseases, Beijing, China
| | - Zhenghua Zhao
- Department of Infectious Disease, Tai'an City Central Hospital, Tai'an, China
| | - Yi Shen
- Department of Infectious Diseases, Dandong Infectious Disease Hospital, Dandong, China
| | - Ronghua Jin
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Infectious Diseases, Beijing, China
| | - Jianping Duan
- Department of Infectious Disease, Qing Dao No 6 People's Hospital, Qingdao, China
| | - Wei Zhang
- Center of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, China
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Luo N, Li M, Xu M, Shi C, Shi X, Ni R, Chen Y, Zheng L, Tu Y, Hu D, Yu C, Li Q, Lu Y. Research Progress of Fever with Thrombocytopenia Syndrome. INTENSIVE CARE RESEARCH 2023; 3:1-10. [PMID: 37360310 PMCID: PMC10033304 DOI: 10.1007/s44231-023-00035-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 02/20/2023] [Indexed: 03/25/2023]
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is a new infectious disease first discovered in Ta-pieh Mountains in central China in 2009. It is caused by a novel bunyavirus infection (SFTSV). Since the first discovery of SFTSV, there have been case reports and epidemiological studies on SFTS in several East Asian countries, such as South Korea, Japan, Vietnam and so on. With the rising incidence of SFTS and the rapid spread of the novel bunyavirus around the world, it is clear that the virus has a pandemic potential and may pose a threat to global public health in the future. Early studies have suggested that ticks are an important medium for the transmission of SFTSV to humans; in recent years, it has been reported that there is also human-to-human transmission. In endemic areas, potential hosts include a variety of livestock and wildlife. When people are infected with SFTV, the main clinical manifestations are high fever, thrombocytopenia, leukocytopenia, gastrointestinal symptoms, liver and kidney function damage, and even MODS, with a mortality rate of about 10-30%. This article reviews the latest progress of novel bunyavirus, including virus transmission vector, virus genotypic diversity and epidemiology, pathogenesis, clinical manifestation and treatment.
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Affiliation(s)
- Ning Luo
- General ICU, Xinyang Central Hospital, Xinyang Key Laboratory of Critical Care Medicine, Xinyang, 464000 Henan China
| | - Mengdie Li
- General ICU, Xinyang Central Hospital, Xinyang Key Laboratory of Critical Care Medicine, Xinyang, 464000 Henan China
| | - Ming Xu
- General ICU, Xinyang Central Hospital, Xinyang Key Laboratory of Critical Care Medicine, Xinyang, 464000 Henan China
| | - Chuanchuan Shi
- General ICU, Xinyang Central Hospital, Xinyang Key Laboratory of Critical Care Medicine, Xinyang, 464000 Henan China
| | - Xinge Shi
- General ICU, Xinyang Central Hospital, Xinyang Key Laboratory of Critical Care Medicine, Xinyang, 464000 Henan China
| | - Rong Ni
- General ICU, Xinyang Central Hospital, Xinyang Key Laboratory of Critical Care Medicine, Xinyang, 464000 Henan China
| | - Yu Chen
- General ICU, Xinyang Central Hospital, Xinyang Key Laboratory of Critical Care Medicine, Xinyang, 464000 Henan China
| | - Liang Zheng
- General ICU, Xinyang Central Hospital, Xinyang Key Laboratory of Critical Care Medicine, Xinyang, 464000 Henan China
| | - Yuling Tu
- General ICU, Xinyang Central Hospital, Xinyang Key Laboratory of Critical Care Medicine, Xinyang, 464000 Henan China
| | - Dan Hu
- General ICU, Xinyang Central Hospital, Xinyang Key Laboratory of Critical Care Medicine, Xinyang, 464000 Henan China
| | - Chunlin Yu
- General ICU, Xinyang Central Hospital, Xinyang Key Laboratory of Critical Care Medicine, Xinyang, 464000 Henan China
| | - Qingying Li
- General ICU, Xinyang Central Hospital, Xinyang Key Laboratory of Critical Care Medicine, Xinyang, 464000 Henan China
| | - Yibin Lu
- General ICU, Xinyang Central Hospital, Xinyang Key Laboratory of Critical Care Medicine, Xinyang, 464000 Henan China
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Qian F, Zhou W, Liu Y, Ge Z, Lai J, Zhao Z, Feng Y, Lin L, Shen Y, Zhang Z, Zhang W, Fan T, Zhao Y, Chen Z. High C-reactive protein to lymphocyte ratio predicts mortality outcomes of patients with severe fever with thrombocytopenia syndrome: A multicenter study in China. J Med Virol 2023; 95:e28546. [PMID: 36734063 DOI: 10.1002/jmv.28546] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 01/01/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023]
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is a life-threatening infectious disease caused by the SFTS virus (SFTSV). This study aimed to evaluate the predictive power of C-reactive protein to lymphocyte ratio (CLR) and establish an early-warning model for SFTS mortality. We retrospectively analyzed hospitalized SFTS patients in six clinical centers from May 2011 to 2022. The efficacy of CLR prediction was evaluated by the receiver operating characteristic (ROC) analysis. A nomogram was established and validated. Eight hundred and eighty-two SFTS patients (median age 64 years, 48.5% male) were enrolled in this study, with a mortality rate of 17.8%. The area under the ROC curve (AUC) of CLR was 0.878 (95% confidence interval [CI]: 0.850-0.903, p < 0.001), which demonstrates high predictive strength. The least absolute shrinkage and selection operator regression selected seven potential predictors. Multivariate logistic regression analysis determined three independent risk factors, including CLR, to construct the nomogram. The performance of the nomogram displayed excellent discrimination and calibration, with significant net benefits in clinical uses. CLR is a brand-new predictor for SFTS mortality. The nomogram based on CLR can serve as a convenient tool for physicians to identify critical SFTS cases in clinical practice.
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Affiliation(s)
- Fang Qian
- Center of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Wei Zhou
- Department of Infectious Diseases, Dalian Sixth People's Hospital, Dalian, China
| | - Yuanni Liu
- Department of Infectious Disease, Yantai City Hospital for Infectious Disease, Yantai, China
| | - Ziruo Ge
- Center of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Jianming Lai
- Department of Infectious Disease, Qing Dao No 6 People's Hospital, Qingdao, China
| | - Zhenghua Zhao
- Department of Infectious Disease, Taian City Central Hospital, Taian, China
| | - Yang Feng
- Department of Infectious Disease, Taian City Central Hospital, Taian, China
| | - Ling Lin
- Department of Infectious Disease, Yantai City Hospital for Infectious Disease, Yantai, China
| | - Yi Shen
- Department of Infectious Diseases, Dandong Infectious Disease Hospital, Dandong, China
| | - Zhonglu Zhang
- Department of Infectious Diseases, Dalian Sixth People's Hospital, Dalian, China
| | - Wei Zhang
- Center of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Tianli Fan
- Department of Infectious Disease, Qing Dao No 6 People's Hospital, Qingdao, China
| | - Yongxiang Zhao
- Department of Infectious Diseases, Dandong Infectious Disease Hospital, Dandong, China
| | - Zhihai Chen
- Center of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, China
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Dong Y, Lin SH, Jiang L, Liu H. Clinical characteristics and risk factors of 267 patients having severe fever with thrombocytopenia syndrome-new epidemiological characteristics of fever with thrombocytopenia syndrome: Epidemiological characteristics of SFTS. Medicine (Baltimore) 2022; 101:e31947. [PMID: 36550925 PMCID: PMC9771163 DOI: 10.1097/md.0000000000031947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To analyze the epidemiological distribution, clinical characteristics, and prognostic risk factors of patients having severe fever with thrombocytopenia syndrome (SFTS). METHODS We enrolled 790 patients with SFTS divided into the ordinary group and the severe group, analyzed the clinical characteristics, and screened the risk factors of severious patients by univariate logistic regression analysis. RESULTS Most of the 790 patients (SFTS) are farmers (84.56%). The proportion of patients with fieldwork history was 72.41%, of which 21.27% had a clear history of a tick bite and 98.61% were sporadic cases. The annual peak season is from April to November. 16.33% patients were not accompanied by fever. The incidence of severe thrombocytopenia was 47.59%. They were statistically significant between the 2 groups in indicators such as age, hypertension, coronary heart disease, diabetes mellitus, bunyavirus nucleic acid load and mean platelet count (P < .05). Multivariate non conditional Logistic regression analysis showed that the risk factors of the mild patients deteriorating severe disease were age (OR = 1.985, P ≤ .003), diabetes mellitus (OR = 1.702, P ≤ .001), coronary heart disease (OR = 1.381, P ≤ .003), platelet count (OR = 2.592, P ≤ .001), viral nucleic acid loading (OR = 3.908, P ≤ .001). CONCLUSION The incidence population and seasonal distribution characteristics of patients with SFTS are obvious. The risk factors for poor prognosis of severe patients are old age, multiple basic medical histories, high viral load, a serious decrease of mean platelet count, and delay of treatment time.
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Affiliation(s)
- Yu Dong
- Department of Gastroenterology, Shandong, Provincial hospital affiliated to Shandong First Medical University, P.R.China
| | - Shao-hua Lin
- Department of Infectious Disease, Rongcheng Hospital Affiliated to Shandong First Medical University, Rongcheng, P.R.China
| | - Ling Jiang
- Department of Clinical Laboratory Center, Rongcheng Hospital Affiliated to Shandong First Medical University, Rongcheng, P.R.China
| | - Hui Liu
- Department of Gastroenterology, Shandong, Provincial hospital affiliated to Shandong University, Jinan, P.R.China
- * Correspondence: Hui Liu, Department of Gastroenterology, Shandong, Provincial hospital affiliated to Shandong University, Jinan 250021, P.R.China (e-mail: )
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Liu Y, Ni J, Xiong Y, Wu C, He F. Neutrophil-to-lymphocyte ratio is associated with 28-day mortality in patients with severe fever with thrombocytopenia syndrome. BMC Infect Dis 2022; 22:225. [PMID: 35249544 PMCID: PMC8898529 DOI: 10.1186/s12879-022-07206-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 02/23/2022] [Indexed: 11/17/2022] Open
Abstract
Objectives To determine the association of the neutrophil-to-lymphocyte ratio (NLR) with 28-day mortality in patients with severe fever with thrombocytopenia syndrome (SFTS). Methods A single-centre retrospective analysis was performed in an emergency department from January 01, 2018, to June 30, 2021. Univariate and multivariable Cox proportional hazards regression models were used to investigate the prognostic factors associated with 28-day mortality. Kaplan–Meier curves were analysed in patients stratified by the optimal cut-off point of the NLR determined using a receiver operating characteristic (ROC) curve. Results In total, 182 SFTS patients were included, and 24 (13.2%) died within 28 days. The median age of the included patients was 59.64 ± 12.74 years, and 48.4% (88/182) were male. The patients in the non-survival group had significantly higher NLRs than those in the survival group (6.91 ± 6.73 vs. 2.23 ± 1.83). The NLR was a significant predictor of 28-day mortality (adjusted HR: 1.121, 95% CI: 1.033, 1.215). The area under the ROC curve of the NLR for predicting 28-day mortality was 0.743 (95% CI: 0.624, 0.862), and the optimal cut-off value was 4.19 (sensitivity, 54.2%; specificity, 89.2%). In addition, 28-day mortality in the patients with an NLR ≥ 4.19 was notably higher than that in the patients with an NLR < 4.19 (43.3% vs. 7.2%), and Kaplan–Meier analysis showed that the patients with an NLR ≥ 4.19 had a significantly lower survival rate than those with an NLR < 4.19. Conclusions The NLR was a significant, independent predictor of 28-day mortality in SFTS patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07206-8.
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Utsunomiya Nishimizu R, Shiota S, Ishii T, Sano K, Suzuki T, Hasegawa H, Miyazaki E. Plasma Exchange Did Not Reduce Viral Load in a Recovered Case of Severe Fever with Thrombocytopenia Syndrome. Intern Med 2022; 61:253-256. [PMID: 34334561 PMCID: PMC8851190 DOI: 10.2169/internalmedicine.7075-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne infectious disease caused by the SFTS virus (SFTSV). There is no specific treatment for SFTS, although several reports have indicated that plasma exchange (PE) can be an effective therapy for severe SFTS. However, whether or not PE can reduce the viral load is unclear. We herein report a woman with SFTS who had her SFTSV viral load measured just before and after PE. While the patient recovered, there was no significant difference in the SFTSV viral load after PE. Our results confirmed that PE itself does not reduce the SFTSV viral load.
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Affiliation(s)
- Rie Utsunomiya Nishimizu
- Department of General Medicine, Oita University Faculty of Medicine, Japan
- Center for Community Medicine, Oita University Faculty of Medicine, Japan
| | - Seiji Shiota
- Department of General Medicine, Oita University Faculty of Medicine, Japan
- Center for Community Medicine, Oita University Faculty of Medicine, Japan
| | - Toshihiro Ishii
- Department of General Medicine, Oita University Faculty of Medicine, Japan
- Center for Community Medicine, Oita University Faculty of Medicine, Japan
| | - Kaori Sano
- Department of Pathology, National Institute of Infectious Diseases, Japan
| | - Tadaki Suzuki
- Department of Pathology, National Institute of Infectious Diseases, Japan
| | - Hideki Hasegawa
- Department of Pathology, National Institute of Infectious Diseases, Japan
| | - Eishi Miyazaki
- Department of General Medicine, Oita University Faculty of Medicine, Japan
- Center for Community Medicine, Oita University Faculty of Medicine, Japan
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10
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Wang B, He Z, Yi Z, Yuan C, Suo W, Pei S, Li Y, Ma H, Wang H, Xu B, Guo W, Huang X. Application of a decision tree model in the early identification of severe patients with severe fever with thrombocytopenia syndrome. PLoS One 2021; 16:e0255033. [PMID: 34329338 PMCID: PMC8324211 DOI: 10.1371/journal.pone.0255033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 07/08/2021] [Indexed: 12/04/2022] Open
Abstract
Background Severe fever with thrombocytopenia syndrome (SFTS) is a serious infectious disease with a fatality of up to 30%. To identify the severity of SFTS precisely and quickly is important in clinical practice. Methods From June to July 2020, 71 patients admitted to the Infectious Department of Joint Logistics Support Force No. 990 Hospital were enrolled in this study. The most frequently observed symptoms and laboratory parameters on admission were collected by investigating patients’ electronic records. Decision trees were built to identify the severity of SFTS. Accuracy and Youden’s index were calculated to evaluate the identification capacity of the models. Results Clinical characteristics, including body temperature (p = 0.011), the size of the lymphadenectasis (p = 0.021), and cough (p = 0.017), and neurologic symptoms, including lassitude (p<0.001), limb tremor (p<0.001), hypersomnia (p = 0.009), coma (p = 0.018) and dysphoria (p = 0.008), were significantly different between the mild and severe groups. As for laboratory parameters, PLT (p = 0.006), AST (p<0.001), LDH (p<0.001), and CK (p = 0.003) were significantly different between the mild and severe groups of SFTS patients. A decision tree based on laboratory parameters and one based on demographic and clinical characteristics were built. Comparing with the decision tree based on demographic and clinical characteristics, the decision tree based on laboratory parameters had a stronger prediction capacity because of its higher accuracy and Youden’s index. Conclusion Decision trees can be applied to predict the severity of SFTS.
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Affiliation(s)
- Bohao Wang
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Zhiquan He
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China
| | - Zhijie Yi
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Chun Yuan
- Joint Logistics Support Force NO.990 Hospital, Xinyang, China
| | - Wenshuai Suo
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Shujun Pei
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yi Li
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China
- Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China
| | - Hongxia Ma
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China
- Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China
| | - Haifeng Wang
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China
| | - Bianli Xu
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China
- Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China
| | - Wanshen Guo
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China
| | - Xueyong Huang
- College of Public Health, Zhengzhou University, Zhengzhou, China
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China
- Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China
- * E-mail:
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11
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Wang X, Ren X, Ge Z, Cui S, Wang L, Chen Z, Tian D. Clinical manifestations of death with severe fever and thrombocytopenia syndrome: A meta-analysis and systematic review. J Med Virol 2021; 93:3960-3968. [PMID: 32930400 DOI: 10.1002/jmv.26518] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/11/2020] [Accepted: 09/12/2020] [Indexed: 01/16/2023]
Abstract
Severe hemorrhagic fever disease is caused by severe fever with thrombocytopenia syndrome virus (SFTSV) infection, which belongs to the Phlebovirus genus in the Bunyaviridae family. A comprehensive literature search of PubMed, Web of Science, Embase, Cochrane Library, Chinese National Knowledge Infrastructure databases, Wan Fang Data, Sinomed Database, and VIP database was conducted for articles which have described the clinical manifestation of deceased patients. Data from selected studies were pooled by using STATA VERSION 15.0 software. Finally, 29 articles comprising 4717 laboratory-confirmed SFTSV cases were included in this analysis. We found there were significant differences between the two groups for fatigue, headache, underlying disease, vomiting, diarrhea, skin bleeding, neurological symptoms, arrhythmia, diffuse intravascular coagulation, and multiple organ failure. There were some significant differences between the fatal and nonfatal groups, and we need to pay more attention to the above symptoms to distinguish between fatal and nonfatal patients.
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Affiliation(s)
- Xiankun Wang
- Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Xingxiang Ren
- Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Ziruo Ge
- Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Shuping Cui
- Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Lin Wang
- Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Zhihai Chen
- Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Di Tian
- Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
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12
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Casel MA, Park SJ, Choi YK. Severe fever with thrombocytopenia syndrome virus: emerging novel phlebovirus and their control strategy. Exp Mol Med 2021; 53:713-722. [PMID: 33953322 PMCID: PMC8178303 DOI: 10.1038/s12276-021-00610-1] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/23/2020] [Accepted: 01/11/2021] [Indexed: 02/03/2023] Open
Abstract
An emerging infectious disease first identified in central China in 2009, severe fever with thrombocytopenia syndrome (SFTS) was found to be caused by a novel phlebovirus. Since SFTSV was first identified, epidemics have occurred in several East Asian countries. With the escalating incidence of SFTS and the rapid, worldwide spread of SFTSV vector, it is clear this virus has pandemic potential and presents an impending global public health threat. In this review, we concisely summarize the latest findings regarding SFTSV, including vector and virus transmission, genotype diversity and epidemiology, probable pathogenic mechanism, and clinical presentation of human SFTS. Ticks most likely transmit SFTSV to animals including humans; however, human-to-human transmission has been reported. The majority of arbovirus transmission cycle includes vertebrate hosts, and potential reservoirs include a variety of both domestic and wild animals. Reports of the seroprevalence of SFTSV in both wild and domestic animals raises the probability that domestic animals act as amplifying hosts for the virus. Major clinical manifestation of human SFTS infection is high fever, thrombocytopenia, leukocytopenia, gastrointestinal symptoms, and a high case-fatality rate. Several animal models were developed to further understand the pathogenesis of the virus and aid in the discovery of therapeutics and preventive measures.
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Affiliation(s)
- Mark Anthony Casel
- College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Republic of Korea
| | - Su Jin Park
- Research Institute of Life Science, Gyeongsang National University, Jinju, Republic of Korea
| | - Young Ki Choi
- College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Republic of Korea.
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13
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Wang L, Zou Z, Ding K, Hou C. Predictive risk score model for severe fever with thrombocytopenia syndrome mortality based on qSOFA and SIRS scoring system. BMC Infect Dis 2020; 20:595. [PMID: 32787952 PMCID: PMC7425036 DOI: 10.1186/s12879-020-05299-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 07/26/2020] [Indexed: 12/03/2022] Open
Abstract
Background Severe fever with thrombocytopenia syndrome (SFTS) is a severe systemic virus infectious disease usually having multi-organ dysfunction which resembles sepsis. Methods Data of 321 patients with laboratory-confirmed SFTS from May 2013 to July 2017 were retrospectively analyzed. Demographic and clinical characteristics, calculated quick sequential organ failure assessment (qSOFA) score and systemic inflammatory response syndrome (SIRS) criteria for survivors and nonsurvivors were compared. Independent risk factors associated with in-hospital mortality were obtained using multivariable logistic regression analysis. Risk score models containing different risk factors for mortality in stratified patients were established whose predictive values were evaluated using the area under ROC curve (AUC). Results Of 321 patients, 87 died (27.1%). Age (p < 0.001) and percentage numbers of patients with qSOFA≥2 and SIRS≥2 (p < 0.0001) were profoundly greater in nonsurvivors than in survivors. Age, qSOFA score, SIRS score and aspartate aminotransferase (AST) were independent risk factors for mortality for all patients. qSOFA score was the only common risk factor in all patients, those age ≥ 60 years and those enrolled in the intensive care unit (ICU). A risk score model containing all these risk factors (Model1) has high predictive value for in-hospital mortality in these three groups with AUCs (95% CI): 0.919 (0.883–0.946), 0.929 (0.862–0.944) and 0.815 (0.710–0.894), respectively. A model only including age and qSOFA also has high predictive value for mortality in these groups with AUCs (95% CI): 0.872 (0.830–0.906), 0.885(0.801–0.900) and 0.865 (0.767–0.932), respectively. Conclusions Risk models containing qSOFA have high predictive validity for SFTS mortality.
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14
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Picón-Jaimes YA, Orozco-Chinome JE, Molina-Franky J, Franky-Rojas MP. Control central de la temperatura corporal y sus alteraciones: fiebre, hipertermia e hipotermia. MEDUNAB 2020. [DOI: 10.29375/01237047.3714] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Introducción. En mamíferos, el control de la temperatura corporal es vital. El estado de consciencia y control motor en humanos, ocurren a una temperatura de 37°C y las desviaciones pueden alterar las propiedades celulares, generando disfunciones fisiológicas. En especies como los roedores (su relación área de superficie/volumen facilita la pérdida de calor) mantienen temperaturas basales cercanas a los 30°C. Distinto es con animales como los paquidermos, cuya temperatura es menor comparada con los humanos. El objetivo es identificar los aspectos fisiológicos de la termorregulación. Descripción de temas tratados. Revisión descriptiva de la literatura de artículos publicados en diferentes bases de datos. La termorregulación es la capacidad del cuerpo para establecer y mantener su temperatura, regulando producción y pérdida de calor para optimizar la eficiencia de procesos metabólicos. El protagonismo lo tiene el sistema nervioso central y su control neuro-hormonal en múltiples niveles. El centro regulador térmico está en el hipotálamo anterior. Este recibe información de los receptores de grandes vasos, vísceras abdominales, médula espinal y de la sangre que perfunde el hipotálamo. Cuando aumenta la temperatura central, el termorregulador activa fibras eferentes del sistema nervioso autónomo, provocando pérdida de calor por convección y evaporación. Ante el descenso de temperatura, la respuesta es disminuir la pérdida de calor (vasoconstricción y menor sudoración); además, incrementar la producción de calor, intensificando la actividad muscular. Conclusión. La termorregulación es liderada por el hipotálamo, quien regula aumento y disminución de la temperatura respondiendo a las necesidades del organismo para llegar a la homeostasis y compensación, enfrentando las alteraciones de la temperatura ambiental
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15
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Liu J, Fu H, Sun D, Wu S, Wang L, Yao M, Yuan G. Analysis of the laboratory indexes and risk factors in 189 cases of severe fever with thrombocytopenia syndrome. Medicine (Baltimore) 2020; 99:e18727. [PMID: 31914089 PMCID: PMC6959874 DOI: 10.1097/md.0000000000018727] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
The current study aimed to analyze the clinical characteristics of severe fever with thrombocytopenia syndrome (SFTS) and to explore the risk factors of critical patients. From 2016 to 2018, we collected the hospitalized diagnosed cases with SFTS in Jinan infectious disease hospital of Shandong University and analyzed by the descriptive epidemiological method. According to the prognosis, they were divided into general group and severe group. The epidemiological characteristics, clinical features, and laboratory indexes of these 2 groups of patients were compared and analyzed at the first visit. The risk factors related to the severity of the disease were analyzed by univariate Logistic regression. In total, 189 cases of SFTS were treated during the period and 33 deaths occurred in the severe group, with the fatality rate of 17.46%. The patients' age (χ = 8.864, P < .01), ALT (Z = -2.304, P = .03), AST (Z = -3.361, P < .01), GLU (t = -4.115, P < .01), CK (Z = -3.964, P < .01), CK-MB (Z = -2.225, P = .03), LDH (Z = -3.655, P < .01), α-HBDH (Z = -2.040, P = .04), APTT (t = -3.355, P < .01), BUN (Z = -2.040, P = .04), Cr (Z = -3.071, P = .01), and D-dimer (Z = -2.026, P = .04) in the severe group were higher than that in the normal group, but the blood platelet (PLT) counts were significantly lower (Z = -2.778, P < .01) than that in the normal group. With the neuropsychiatric symptoms (OR = 24.083, 95% CI = 6.064-95.642), skin bleeding point (OR = 30.000, 95% CI = 6.936-129.764), multiple organ dysfunction (OR = 34.048, 95% CI = 7.740-149.782), past medical history (OR = 3.792, 95% CI = 1.284-11.200), and fasting glucose elevation (OR = 1.359, 95% CI = 1.106-1.668) could predict the severity of the SFTS. In summary, the abnormality of the laboratory index, the special clinical manifestations, and the past medical history of SFTS patients were the important basis for judging the patient's serious condition.
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Affiliation(s)
- Jingwen Liu
- Department of Clinical Laboratory, Jinan Infectious Disease Hospital Affiliated to Shandong University
| | - Hongmei Fu
- Jinan Blood Supply and Security Center of Shandong Province
| | - Dapeng Sun
- Institute for Viral Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan
| | - Shuzhi Wu
- Institute for Viral Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan
| | - Li Wang
- Department of Clinical Laboratory, Jinan Infectious Disease Hospital Affiliated to Shandong University
| | - Mingxiao Yao
- Institute for Viral Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan
| | - Guangying Yuan
- Department of Clinical Laboratory, Jinan Infectious Disease Hospital Affiliated to Shandong University
- Collaborative Innovation Center for the Origin and Control of Emerging Infectious Diseases, Taishan Medical University, Taian, Shandong Province, China
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16
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Wang L, Wan G, Shen Y, Zhao Z, Lin L, Zhang W, Song R, Tian D, Wen J, Zhao Y, Yu X, Liu L, Feng Y, Liu Y, Qiang C, Duan J, Ma Y, Liu Y, Liu Y, Chen C, Ge Z, Li X, Chen Z, Fan T, Li W. A nomogram to predict mortality in patients with severe fever with thrombocytopenia syndrome at the early stage-A multicenter study in China. PLoS Negl Trop Dis 2019; 13:e0007829. [PMID: 31765414 PMCID: PMC6934327 DOI: 10.1371/journal.pntd.0007829] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 12/27/2019] [Accepted: 10/04/2019] [Indexed: 12/26/2022] Open
Abstract
Background Severe fever with thrombocytopenia syndrome (SFTS) caused by the SFTS virus is an emerging infectious disease that was first identified in the rural areas of China in 2011. Severe cases often result in death due to multiple organ failure. To date, there are still numerous problems remain unresolved in SFTS, including unclear pathogenesis, lack of specific treatment, and no effective vaccines available. Aim To analyze the clinical information of patients with early-stage SFTS and to establish a nomogram for the mortality risk. Methods Between April 2011 and December 2018, data on consecutive patients who were diagnosed with SFTS were prospectively collected from five medical centers distributed in central and northeastern China. Multivariable Cox analyses were used to identify the factors independently associated with mortality. A nomogram for mortality was established using those factors. Results During the study period, 429 consecutive patients were diagnosed with SFTS at the early stage of the disease (within 7 days of fever), among whom 69 (16.1%) died within 28 days. The multivariable Cox proportional hazard regression analysis showed that low lymphocyte percentage, early-stage encephalopathy, and elevated concentration of serum LDH and BUN were independent risk factors for fatal outcomes. Received-operating characteristic curves for 7-, 14-, and 28-days survival had AUCs of 0.944 (95% CI: 0.920–0.968), 0.924 (95% CI: 0.896–0.953), and 0.924 (95% CI: 0.895–0.952), respectively. Among low-risk patients, 6 patients died (2.2%). Among moderate-risk patients, 25 patients died (24.0%, hazard ratio (HR) = 11.957). Among high-risk patients, the mortality rate was 69.1% (HR = 57.768). Conclusion We established a simple and practical clinical scoring system, through which we can identify critically ill patients and provide intensive medical intervention for patients as soon as possible to reduce mortality. We established a SFTS nomogram scoring system, which is the first nomogram for this disease. According to this nomogram, patients were divided into three levels of mortality risk: low, moderate, and high. This scoring system is helpful to identify critically ill patients, allowing for early intervention and intensive care, which may contribute to reducing the mortality of SFTS.
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Affiliation(s)
- Lin Wang
- Center of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Gang Wan
- Statistics Room, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Yi Shen
- Department of Infectious Diseases, Dandong Infectious Disease Hospital, Dandong, China
| | - Zhenghua Zhao
- Department of Infectious Disease, Taian City Central Hospital, Taian, China
| | - Ling Lin
- Department of Infectious Disease, Yantai City Hospital for Infectious Disease, Yantai, China
| | - Wei Zhang
- Center of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Rui Song
- Center of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Di Tian
- Center of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Jing Wen
- Center of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Yongxiang Zhao
- Department of Infectious Diseases, Dandong Infectious Disease Hospital, Dandong, China
| | - Xiaoli Yu
- Department of Infectious Diseases, Dandong Infectious Disease Hospital, Dandong, China
| | - Li Liu
- Department of Infectious Disease, Taian City Central Hospital, Taian, China
| | - Yang Feng
- Department of Infectious Disease, Taian City Central Hospital, Taian, China
| | - Yuanni Liu
- Department of Infectious Disease, Yantai City Hospital for Infectious Disease, Yantai, China
| | - Chunqian Qiang
- Department of Infectious Disease, Yantai City Hospital for Infectious Disease, Yantai, China
| | - Jianping Duan
- Department of Infectious Disease, Qing Dao No. 6 People's Hospital, Qingdao, China
| | - Yanli Ma
- Department of Infectious Disease, Qing Dao No. 6 People's Hospital, Qingdao, China
| | - Ying Liu
- Clinical Laboratory, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Yanan Liu
- Clinical Laboratory, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Chong Chen
- Graduate School of Capital Medical University, Beijing, China
| | - Ziruo Ge
- Graduate School of Capital Medical University, Beijing, China
| | - Xingwang Li
- Center of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Zhihai Chen
- Center of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Tianli Fan
- Department of Infectious Disease, Qing Dao No. 6 People's Hospital, Qingdao, China
| | - Wei Li
- Interventional Therapy Oncology, Beijing Ditan Hospital, Capital Medical University, Beijing, China
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17
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Yu MA, Yu KM, Park SJ, Kim YI, Robles NJ, Si YJ, Kim EH, Kwon HI, Jeong HW, Song MS, Kim SY, Choi YK. Seroprevalence of Severe Fever with Thrombocytopenia Syndrome Phlebovirus in Domesticated Deer in South Korea. Virol Sin 2019; 34:501-507. [PMID: 31240618 DOI: 10.1007/s12250-019-00137-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 04/22/2019] [Indexed: 10/26/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome phlebovirus (SFTSV) has a wide host range. Not only has it been found in humans, but also in many wild and domesticated animals. The infection of breeding deer on farms is a particularly worrisome public health concern due to the large amount of human contact and the diverse use of deer products, including raw blood. To investigate the prevalence of breeding domesticated deer, we examined the SFTSV infection rate on deer farms in South Korea from 2015 to 2017. Of the 215 collected blood samples, 0.9% (2/215) were found to be positive for viral RNA by PCR, and sequence analysis showed the highest homology with the KADGH human isolate. Both SFTSV-specific recombinant N and Gn protein-based ELISAs revealed that 14.0% (30/215) and 7.9% (17/215) of collected blood specimens were positive for SFTSV antibody. These results demonstrate that the breeding farm deer are exposed to SFTSV and could be a potential infection source for humans through direct contact or consumption of byproducts.
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Affiliation(s)
- Min-Ah Yu
- Department of Microbiology, College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, 28644, Republic of Korea.,Zoonotic Infectious Diseases Research Center, Chungbuk National University, Cheongju, 28644, Republic of Korea
| | - Kwang-Min Yu
- Department of Microbiology, College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, 28644, Republic of Korea.,Zoonotic Infectious Diseases Research Center, Chungbuk National University, Cheongju, 28644, Republic of Korea
| | - Su-Jin Park
- Department of Microbiology, College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, 28644, Republic of Korea.,Zoonotic Infectious Diseases Research Center, Chungbuk National University, Cheongju, 28644, Republic of Korea
| | - Young-Il Kim
- Department of Microbiology, College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, 28644, Republic of Korea.,Zoonotic Infectious Diseases Research Center, Chungbuk National University, Cheongju, 28644, Republic of Korea
| | - Norbert John Robles
- Department of Microbiology, College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, 28644, Republic of Korea.,Zoonotic Infectious Diseases Research Center, Chungbuk National University, Cheongju, 28644, Republic of Korea
| | - Young-Jae Si
- Department of Microbiology, College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, 28644, Republic of Korea.,Zoonotic Infectious Diseases Research Center, Chungbuk National University, Cheongju, 28644, Republic of Korea
| | - Eun-Ha Kim
- Department of Microbiology, College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, 28644, Republic of Korea.,Zoonotic Infectious Diseases Research Center, Chungbuk National University, Cheongju, 28644, Republic of Korea
| | - Hyeok-Il Kwon
- Department of Microbiology, College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, 28644, Republic of Korea.,Zoonotic Infectious Diseases Research Center, Chungbuk National University, Cheongju, 28644, Republic of Korea
| | - Hye Won Jeong
- Department of Internal Medicine, College of Medicine and Medical Research Institute, Cheongju, 28644, Republic of Korea.,Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, 28644, Republic of Korea
| | - Min-Suk Song
- Department of Microbiology, College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, 28644, Republic of Korea.,Zoonotic Infectious Diseases Research Center, Chungbuk National University, Cheongju, 28644, Republic of Korea
| | - Seok-Yong Kim
- Department of Microbiology, College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, 28644, Republic of Korea
| | - Young Ki Choi
- Department of Microbiology, College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, 28644, Republic of Korea. .,Zoonotic Infectious Diseases Research Center, Chungbuk National University, Cheongju, 28644, Republic of Korea.
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18
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A scoring model for predicting prognosis of patients with severe fever with thrombocytopenia syndrome. PLoS Negl Trop Dis 2017; 11:e0005909. [PMID: 28934195 PMCID: PMC5626493 DOI: 10.1371/journal.pntd.0005909] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 10/03/2017] [Accepted: 08/27/2017] [Indexed: 12/04/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging epidemic infectious disease caused by the SFTS bunyavirus (SFTSV) with an estimated high case-fatality rate of 12.7% to 32.6%. Currently, the disease has been reported in mainland China, Japan, Korea, and the United States. At present, there is no specific antiviral therapy for SFTSV infection. Considering the higher mortality rate and rapid clinical progress of SFTS, supporting the appropriate treatment in time to SFTS patients is critical. Therefore, it is very important for clinicians to predict these SFTS cases who are more likely to have a poor prognosis or even more likely to decease. In the present study, we established a simple and feasible model for assessing the severity and predicting the prognosis of SFTS patients with high sensitivity and specificity. This model may aid the physicians to immediately initiate prompt treatment to block the rapid development of the illness and reduce the fatality of SFTS patients. Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by a novel SFTS bunyavirus (SFTSV) with an estimated high case-fatality rate. However, there is no specific antiviral therapy for SFTSV infection. Symptomatic treatment and supportive therapy are the most essential part of case management. It is very important for clinicians to identify critical patients at admission. In this study, we established a simple and feasible scoring system for assessing the severity and predicting the prognosis of SFTS patients with objective parameters. This model may help the physicians to perform intervention measures in advance, control the disease progression and improve the prognosis.
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