Efficacy of high-dose methylprednisolone in patients with Crimean-Congo haemorrhagic fever and severe thrombocytopenia

Sharifi-Mood, Batool; Alavi-Naini, Roya; Metanat, Maliheh; Mohammadi, Mehdi; Shakeri, Asadollah; Amjadi, A.R.

doi:10.1177/0049475513486642

Cited by 21 publications

(20 citation statements)

References 15 publications

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“…In the Iranian study, high dose methylprednisolone was tried in 13 patients with severe thrombocytopenia at presentation and results were compared to 22 patients with the same presentation. The result showed that treatment group had faster recovery in platelet and WBC counts compared to controls (28).…”

Section: Steroidsmentioning

confidence: 90%

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Crimean-Congo Hemorrhagic Fever-Treatment and Preventive Strategies

Jahromi

2014

Int J Infect

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Crimean-Congo hemorrhagic fever is a tick-borne viral disease reported from more than 30 countries in Africa, Asia, South-East Europe, and the Middle East. The majority of human cases are workers in livestock industry, agriculture, slaughterhouses, and veterinary practice. The current mortality rate in endemic areas varies between 5 to 20 percent depending on the geographic location and medical supportive treatment. Unfortunately, there is currently no FDA-approved vaccine for prevention or specific antiviral drug for the treatment of CCHF. Ribavirin, effective against CCHFV in vitro, is one of the few options for treatment of CCHFV, but its efficacy is still questionable due to contradictory clinical studies. The efficacy of other options including Intravenous Immuneglobulin (IVIG), steroids, CCHF hyperimmuneglobulin, and CCHF monoclonal antibodies is still controversial.

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Section: Steroidsmentioning

confidence: 90%

“…Role of high dose steroids has been studied in only one clinical trial in Iran (28), though it has been evaluated in other studies in Turkey (29). In the Iranian study, high dose methylprednisolone was tried in 13 patients with severe thrombocytopenia at presentation and results were compared to 22 patients with the same presentation.…”

Section: Steroidsmentioning

confidence: 99%

Crimean-Congo Hemorrhagic Fever-Treatment and Preventive Strategies

Jahromi

2014

Int J Infect

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“…A clinical trial evaluated the efficacy of high dose prednisolone in patients with CCHF and severe thrombocytopenia and showed positive effects on increasing platelet count and reduction in the need for blood products in these patients (19). Considering the importance of the disease, the risk of high mortality and lack of assessing the effect of dexamethasone on clinical outcomes, this study aimed at examining the effect of ribavirin in combination with dexamethasone in patients with a severe form of CCHF and comparing the results with those of the patients who took ribavirin alone.…”

Section: Introductionmentioning

confidence: 99%

Effects of Dexamethasone on Clinical Outcome in Patients with Severe Crimean-Congo Hemorrhagic Fever

et al. 2017

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Background: Crimean-Congo hemorrhagic fever (CCHF) is an acute viral hemorrhagic disease, and it is currently endemic in Southeastern Iran. The present study aimed at comparing the effect of ribavirin alone and in combination with dexamethasone on clinical outcome of patients with severe form of Crimean-Congo hemorrhagic fever. Methods: In this clinical trial study, we studied 30 patients with severe form of Crimean-Congo hemorrhagic fever (2 groups with 14 controls and 16 cases), who were admitted to Boo Ali hospital in Zahedan (Southeast of Iran) from July 2015 to April 2016. Patients were selected randomly for each group. The intervention group received dexamethasone and ribavirin, and the control group was treated only with ribavirin. Then, the rate of recovery, mortality rate, blood products used, and duration of hospitalization in both groups were recorded and compared. The distribution of samples and comparison of quantitative variables were evaluated by Kolmogorov Smirnov test, t test, and Man-Whitney test. The comparison of qualitative variables was performed by Chi-square and McNamara's test. Results: Of 30 patients, 24 (80%) and 6 (20%) were male and female, respectively. A few patients required transfusion of blood products in the intervention group compared to controls, but there was no statistically significant difference between the 2 groups (P < 0.05). The mean duration of hospitalization was 10.87 and 12 days in the intervention and control groups, respectively. No significant difference was obtained between the 2 groups in the duration of recovery (P < 0.05). No patients died in the intervention and control groups. Conclusions: It seems that high-dose dexamethasone is effective in the treatment of patients with severe form of CCHF. Blood products requirement for severe CCHF patients was reduced after receiving high-dose dexamethasone. Further investigations are necessary to determine the efficacy of corticosteroid and its effect on outcome.

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“…Death mainly occurs in the second week of disease and in patients who have survived, improvement begins about 10 days after the onset of illness (2,3,6). CCHF virus infection can be diagnosed by several different laboratory tests such as enzyme-linked immunosorbent assay (ELISA), serum neutralization (SN), reverse transcriptase polymerase chain reaction (RT-PCR) assay, and by cell culture to isolate the virus (12)(13)(14).Treatment is supportive, but ribavirin (an anti viral drug, both oral and intravenous formulations) has been used to treat CCHF infection with apparent benefit in previous reports (15)(16)(17)(18)(19)(20)(21)(22). Prevention of the virus in animals is difficult because infection in animals is usually not symptomatic.…”

Section: Introductionmentioning

confidence: 99%

Report of a Family with Crimean-Congo Hemorrhagic Fever Following Contact with Frozen Meat: A Case Seires Study

Metanat¹,

Sharifi-Mood²,

Fathollahzadeh³

et al. 2017

Arch Clin Infect Dis

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Introduction: Crimean-Congo hemorrhagic fever (CCHF) is caused by a tick-borne virus in the family of Bunyaviridae. A hard tick, in the genus of Hyalomma, is a reservoir and also a vector for CCHF virus. Infection in humans usually occurs by infected tick bite or through contact with infected animal tissues and blood. CCHF can also transmit from one infected person to another through contact with infectious blood or body fluids. Human-to human transmission is also reported as a nosocomial infection. Case Presentation: Here, we presented 5 patients from a family with Crimean-Congo hemorrhagic fever, who got the illness at the same time when they cut the frozen meat together. Fortunately, all patients referred to hospital soon and received treatment during 24 to 72 hours after the first sign or symptom was presented. Conclusions: Frozen meat can transmit CCHFV to humans, which can be due to high viral load or a virus with high virulence in the infected animal tissues.

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Efficacy of high-dose methylprednisolone in patients with Crimean-Congo haemorrhagic fever and severe thrombocytopenia

Cited by 21 publications

References 15 publications

Crimean-Congo Hemorrhagic Fever-Treatment and Preventive Strategies

Crimean-Congo Hemorrhagic Fever-Treatment and Preventive Strategies

Effects of Dexamethasone on Clinical Outcome in Patients with Severe Crimean-Congo Hemorrhagic Fever

Report of a Family with Crimean-Congo Hemorrhagic Fever Following Contact with Frozen Meat: A Case Seires Study

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