Crimean‐Congo haemorrhagic fever‐induced liver injury: A systematic review and meta‐analysis

Rathore, Sawai Singh; Manju, Ade Harrison; Wen, Qingqing; Sondhi, Manush; Pydi, Reshma; Haddad, Iskander; Hasan, Jamal; Ali, Muhammad; Tousif, Sohaib; Singh, Romil; Muhammed, Abdul-Azeez; Ahmed, Naveed; Patel, Deep

doi:10.1111/ijcp.14775

Cited by 8 publications

(5 citation statements)

References 38 publications

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“…Deranged liver parameters are one of the most expected findings in hemorrhagic viral infections, usually manifested as raised bilirubin and transaminases. The severity of the liver injury depends on the magnitude of ALT elevation [ 12 ]. The trend of ALT in this case series highlights that a declining pattern of ALT has a good prognostic value compared to the actual level of ALT at presentation.…”

Section: Discussionmentioning

confidence: 99%

“…Acute hepatitis was defined as ALT more than five times the upper limit of the normal range (ULN). Moreover, liver involvement was categorized as mild (ALT < 5 times ULN), moderate (ALT between 5 to 10 times ULN), and severe (ALT > 10 times ULN) [ 12 ]. The increase in CRP was categorized as mild (0.3 to 1 mg/dL), moderate (1 to 10 mg/dL), and marked (>10 mg/dL) [ 13 ].…”

Section: Methodsmentioning

confidence: 99%

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Crimean-Congo Hemorrhagic Fever Case Series: a Chronology of Biochemical and Hematological Parameters

Amin¹,

Rahim²,

Mahmood³

et al. 2022

Cureus

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IntroductionCrimean-Congo hemorrhagic fever (CCHF) is a widespread tick-borne zoonotic disease. Sporadic outbreaks of CCHF occur in endemic regions, including Pakistan. The clinical spectrum of the illness varies from asymptomatic seroconversion to severe disease which may end in death. The treatment is supportive, including blood and blood products. There is multi-organ involvement in CCHF including acute hepatitis, thrombocytopenia, coagulopathy, acute kidney injury (AKI), and encephalopathy. Hematological and biochemical parameters may identify patients at substantial risk of worse outcomes. Early detection of the disease and forecasting the clinical course may be helpful. This case series aims to evaluate the trends of hematological and biochemical parameters among the survivors and non-survivors of CCHF. MethodsAll consecutive patients aged 16 years and above admitted to the isolation unit of Hayatabad Medical Complex, Peshawar, Pakistan between 1 st July and 30 th July 2022 with the diagnosis of CCHF were included in this case series. The diagnosis of CCHF was made by detecting viral ribonucleic acid by a polymerase chain reaction. For all patients, age, gender, address, occupation, clinical presentation, history of contact with animals, and travel history were recorded. All the vitals were taken regularly. The hematological (complete blood count) and biochemical parameters (serum creatinine, alanine aminotransferase (ALT), and C-reactive protein (CRP)) were documented daily. The blood group was determined for all the cases. ResultsOut of 17 cases, the majority (16 cases, 94.1%) were male and butchers (eight cases, 47.1%) by profession. All cases had significant contact with animals. Four patients (23.5%) died. Three out of the four non-survivors (75%) had ALT < 5 times the upper limit of normal with a static pattern of liver enzymes without much decline in ALT till death. One non-survivor (25%) had marked elevation of ALT at presentation, which had a declining trend till death. Seven out of 13 survivors (53.8%) had moderate to marked elevation in the level of ALT at presentation. The ALT showed a downward trend during the course of illness in all these patients. The remaining survivors (six out of 13, 46.2%) had a mild elevation of ALT and 50% of them showed improvement in the ALT level during hospitalization. All patients had thrombocytopenia at presentation. None of the non-survivors showed a persistent increase in the platelet count, and three cases remained severely thrombocytopenic at the time of death. However, the trend in platelet count among all the survivors was increasing. The CRP level in the majority (three out of four cases, 75%) of the non-survivors remained elevated till death, while all survivors showed a progressive decline in CRP level. A majority (11 out of 17 cases) had blood group B. Half of the non-survivors (two out of four cases) and the majority of the survivors (nine out of 13 cases) had blood group B. AKI was found in all non-survivors, while all the survivors had normal renal f...

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Crimean-Congo Hemorrhagic Fever Case Series: a Chronology of Biochemical and Hematological Parameters

Amin¹,

Rahim²,

Mahmood³

et al. 2022

Cureus

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“…CCHFV, which causes CCHF, is one of the most severe viral diseases in humans. The virus is transmitted via ixodid ticks, particularly those of the genus Hyalomma , and is initially characterized by unspecific signs and symptoms ( Rathore et al, 2021 ). The CCHFV genome is a tri-segmented, negative-sense ssRNA with a conserved 3′ and complementary 5′ ends, allowing the RNA to form a looped structure.…”

Section: Crimean-congo Hemorrhagic Fever Virusmentioning

confidence: 99%

Geographical distribution and pathogenesis of ticks and tick-borne viral diseases

Shah

Wang

et al. 2023

Front. Microbiol.

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Ticks are obligatory hematophagous arthropods that harbor and transmit infectious pathogens to humans and animals. Tick species belonging to Amblyomma, Ixodes, Dermacentor, and Hyalomma genera may transmit certain viruses such as Bourbon virus (BRBV), Dhori virus (DHOV), Powassan virus (POWV), Omsk hemorrhagic fever virus (OHFV), Colorado tick fever virus (CTFV), Crimean-Congo hemorrhagic fever virus (CCHFV), Heartland virus (HRTV), Kyasanur forest disease virus (KFDV), etc. that affect humans and certain wildlife. The tick vectors may become infected through feeding on viraemic hosts before transmitting the pathogen to humans and animals. Therefore, it is vital to understand the eco-epidemiology of tick-borne viruses and their pathogenesis to optimize preventive measures. Thus this review summarizes knowledge on some medically important ticks and tick-borne viruses, including BRBV, POWV, OHFV, CTFV, CCHFV, HRTV, and KFDV. Further, we discuss these viruses’ epidemiology, pathogenesis, and disease manifestations during infection.

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“…In these models, the mice exhibit a variety of pathogenic features including liver damage, gastrointestinal disorders, and neurovirulence. Notably liver damage is a representative pathological feature commonly found in a variety of orthonairovirus-infected mice [15][16][17][18][20][21][22] and also in human CCHF patients [2,[23][24][25][26]. Elevated levels of liver enzymes in YEZV patients suggest that YEZV infection may also potentially cause liver damage in humans.…”

Section: Introductionmentioning

confidence: 99%

Establishment of a lethal mouse model of emerging tick-borne orthonairovirus infections

Ariizumi,

Tabata,

Itakura

et al. 2024

PLoS Pathog

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Emerging and reemerging tick-borne orthonairovirus infections (family Nairoviridae), which are genetically distinct from Crimean-Congo hemorrhagic fever virus, have been recently reported in East Asia. Here, we have established a mouse infection model using type-I/II interferon receptor-knockout mice (AG129) both for a better understanding the pathogenesis of these infections and validation of antiviral agents using Yezo virus (YEZV), a novel virus causing febrile illnesses associated with tick bites in Japan and China. YEZV-inoculated AG129 mice developed hepatitis with body weight loss and died by 6 days post infection. Blood biochemistry tests showed elevated liver enzyme levels, similar to YEZV-infected human patients. AG129 mice treated with favipiravir survived lethal YEZV infection, demonstrating the anti-YEZV effect of this drug. The present mouse model will help us better understand the pathogenicity of the emerging tick-borne orthonairoviruses and the development of specific antiviral agents for their treatment.

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Crimean‐Congo haemorrhagic fever‐induced liver injury: A systematic review and meta‐analysis

Cited by 8 publications

References 38 publications

Crimean-Congo Hemorrhagic Fever Case Series: a Chronology of Biochemical and Hematological Parameters

Crimean-Congo Hemorrhagic Fever Case Series: a Chronology of Biochemical and Hematological Parameters

Geographical distribution and pathogenesis of ticks and tick-borne viral diseases

Establishment of a lethal mouse model of emerging tick-borne orthonairovirus infections

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