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Yang M, Yang Y, Zhang A, Ni M, Liang M, Quan B, Han W, Yang J. Pancreatic Injury Is Associated with Poor Prognosis in Severe Fever with Thrombocytopenia Syndrome. Jpn J Infect Dis 2024; 77:121-128. [PMID: 38171850 DOI: 10.7883/yoken.jjid.2022.571] [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] [Indexed: 01/05/2024]
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease. Previous studies have primarily focused on the epidemiological and clinical characteristics of patients with SFTS, whereas pancreatic injury has received little attention. This study investigated the effects of pancreatic injury on the prognosis of patients with SFTS. A total of 156 patients diagnosed with SFTS between April 2016 and April 2022 were included in the analysis. Multivariate logistic regression analysis showed that pancreatic injury (odds ratio [OR] = 3.754, 95% confidence interval [CI]: 1.361-79.036, P = 0.024) and neurological symptoms (OR = 18.648, 95% CI: 4.921-70.668, P < 0.001) were independent risk factors for mortality. The receiver operating characteristic curve indicated that serum pancreatic enzymes were predictive of progression to death in patients with SFTS. The area under the curve (AUC) for amylase was 0.711, with an optimal cutoff value of 95.5 U/L, sensitivity of 96.4%, and specificity of 35.9%. Lipase had an AUC of 0.754, an optimal cutoff value of 354.75 U/L, sensitivity of 75%, and specificity of 67.2%. Thus, pancreatic injury was associated with a poor prognosis of SFTS and can be used as an important reference for SFTS determination and prognostic assessment.
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Affiliation(s)
- Mengke Yang
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, China
| | - Yang Yang
- Class 1, Grade 2019, Department of Stomatology, Bengbu Medical College, China
| | - Aiping Zhang
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, China
| | - Mingyue Ni
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, China
| | - Manman Liang
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, China
| | - Bin Quan
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, China
| | - Wenzheng Han
- Department of Clinical Laboratory, The First Affiliated Hospital of Wannan Medical College, China
| | - Jianghua Yang
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, China
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Kim CM, Kim DM, Bang MS, Seo JW, Yun NR, Kim DY, Han MA, Hwang JH, Park SK. The Seroprevalence of Severe Fever with Thrombocytopenia Syndrome: An Epidemiological Study of Korean Veterinary Hospital Workers. Viruses 2023; 15:v15030609. [PMID: 36992318 PMCID: PMC10052674 DOI: 10.3390/v15030609] [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: 10/26/2022] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 02/25/2023] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is a zoonotic tick-borne infectious disease caused by the SFTS virus (SFTSV). Few studies have assessed SFTS seroprevalence among veterinary hospital staff and their awareness of SFTS. From January to May 2021, serum samples from 103 veterinary hospital staff were tested for SFTS using an enzyme-linked immunosorbent assay (ELISA), an immunofluorescence assay, and a 50% plaque reduction neutralization antibody test, which yielded positive results in four (3.9%), three (2.9%), and two (1.9%) participants, respectively. A questionnaire was used for an epidemiological investigation. ELISA positivity was higher among those who lacked awareness of possible animal-to-human SFTS transmission (p = 0.029). SFTS awareness was significantly lower among veterinary hospital staff than among the veterinarians (p < 0.001). Providing staff with training concerning standard precautions and the use of appropriate personal protective equipment is important.
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Affiliation(s)
- Choon-Mee Kim
- Premedical Science, College of Medicine, Chosun University, Gwangju 61452, Republic of Korea
| | - Dong-Min Kim
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju 61452, Republic of Korea
- Correspondence: ; Tel.: +82-62-220-3108; Fax: +82-62-234-9653
| | - Mi-Seon Bang
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju 61452, Republic of Korea
| | - Jun-Won Seo
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju 61452, Republic of Korea
| | - Na-Ra Yun
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju 61452, Republic of Korea
| | - Da-Young Kim
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju 61452, Republic of Korea
| | - Mi-Ah Han
- Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju 61452, Republic of Korea
| | - Ji-Hye Hwang
- Division of Control for Zoonotic and Vector Borne Disease, Korea Disease Control and Prevention Agency, Cheongju-si 28159, Republic of Korea
| | - Sook-Kyung Park
- Division of Control for Zoonotic and Vector Borne Disease, Korea Disease Control and Prevention Agency, Cheongju-si 28159, Republic of Korea
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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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Ge HH, Wang G, Guo PJ, Zhao J, Zhang S, Xu YL, Liu YN, Ye XL, Wu YX, Li S, Yue M, Ji WJ, Geng SY, Li H, Zhang XA, Yang ZD, Cui N, Li W, Lin L, Liu W. Coinfections in hospitalized patients with severe fever with thrombocytopenia syndrome: A retrospective study. J Med Virol 2022; 94:5933-5942. [PMID: 36030552 DOI: 10.1002/jmv.28093] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/11/2022] [Accepted: 08/22/2022] [Indexed: 01/06/2023]
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne disease with a high case fatality rate. Few studies have been performed on bacterial or fungal coinfections or the effect of antibiotic therapy. A retrospective, observational study was performed to assess the prevalence of bacterial and fungal coinfections in patients hospitalized for SFTSV infection. The most commonly involved microorganisms and the effect of antimicrobial therapy were determined by the site and source of infection. A total of 1201 patients hospitalized with SFTSV infection were included; 359 (29.9%) had microbiologically confirmed infections, comprised of 292 with community-acquired infections (CAIs) and 67 with healthcare-associated infections (HAIs). Death was independently associated with HAIs, with a more significant effect than that observed for CAIs. For bacterial infections, only those acquired in hospitals were associated with fatal outcomes, while fungal infection, whether acquired in hospital or community, was related to an increased risk of fatal outcomes. The infections in the respiratory tract and bloodstream were associated with a higher risk of death than that in the urinary tract. Both antibiotic and antifungal treatments were associated with improved survival for CAIs, while for HAIs, only antibiotic therapy was related to improved survival, and no effect from antifungal therapy was observed. Early administration of glucocorticoids was associated with an increased risk of HAIs. The study provided novel clinical and epidemiological data and revealed risk factors, such as bacterial coinfections, fungal coinfections, infection sources, and treatment strategies associated with SFTS deaths/survival. This report might be helpful in curing SFTS and reducing fatal SFTS.
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Affiliation(s)
- Hong-Han Ge
- State Key Laboratory Of Pathogen And Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China
| | - Gang Wang
- State Key Laboratory Of Pathogen And Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China
| | - Pei-Jun Guo
- Yantai Center for Disease Control and Prevention, Yantai, Shandong Province, People's Republic of China
| | - Jing Zhao
- State Key Laboratory Of Pathogen And Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China.,General Demonstration Research Room of Aeromedicine, Air Force Medical Center, Beijing, People's Republic of China
| | - Shuai Zhang
- Department of Clinical Laboratory, Yantai Qishan Hospital, Yantai, Shandong Province, People's Republic of China
| | - Yan-Li Xu
- Department of Infectious Diseases, Yantai Qishan Hospital, Yantai, Shandong Province, People's Republic of China
| | - Yuan-Ni Liu
- Department of Infectious Diseases, Yantai Qishan Hospital, Yantai, Shandong Province, People's Republic of China
| | - Xiao-Lei Ye
- The Center for Disease Prevention and Control in Western Theater Command of PLA Joint Logistic Support Force, Lanzhou, Gansu Province, People's Republic of China
| | - Yong-Xiang Wu
- State Key Laboratory Of Pathogen And Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China
| | - Shuang Li
- State Key Laboratory Of Pathogen And Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China
| | - Ming Yue
- Department of Infectious Diseases, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, People's Republic of China
| | - Wen-Juan Ji
- Department of Infectious Diseases, Yantai Qishan Hospital, Yantai, Shandong Province, People's Republic of China
| | - Shu-Ying Geng
- Department of Infectious Diseases, Yantai Qishan Hospital, Yantai, Shandong Province, People's Republic of China
| | - Hao Li
- State Key Laboratory Of Pathogen And Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China
| | - Xiao-Ai Zhang
- State Key Laboratory Of Pathogen And Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China
| | - Zhen-Dong Yang
- The 990th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Xinyang, Henan Province, People's Republic of China
| | - Ning Cui
- The 990th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Xinyang, Henan Province, People's Republic of China
| | - Wei Li
- The 990th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Xinyang, Henan Province, People's Republic of China
| | - Ling Lin
- Department of Infectious Diseases, Yantai Qishan Hospital, Yantai, Shandong Province, 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.,Beijing Key Laboratory of Vector Borne and Natural Focus Infectious Diseases, Beijing, People's Republic of China
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Clinical Update of Severe Fever with Thrombocytopenia Syndrome. Viruses 2021; 13:v13071213. [PMID: 34201811 PMCID: PMC8310018 DOI: 10.3390/v13071213] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/18/2021] [Accepted: 06/18/2021] [Indexed: 12/17/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an acute febrile illness characterized by fever, leukopenia, thrombocytopenia, and gastrointestinal symptoms such as diarrhea, nausea, and vomiting resulting from infection with the SFTS virus (SFTSV). The SFTSV is transmitted to humans by tick bites, primarily from Haemaphysalis longicornis, Amblyomma testudinarium, Ixodes nipponensis, and Rhipicephalus microplus. Human-to-human transmission has also been reported. Since the first report of an SFTS patient in China, the number of patients has also been increasing. The mortality rate of patients with SFTS remains high because the disease can quickly lead to death through multiple organ failure. In particular, an average fatality rate of approximately 20% has been reported for SFTS patients, and no treatment strategy has been established. Therefore, effective antiviral agents and vaccines are required. Here, we aim to review the epidemiology, clinical manifestations, laboratory diagnosis, and various specific treatments (i.e., antiviral agents, steroids, intravenous immunoglobulin, and plasma exchange) that have been tested to help to cope with the disease.
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