Pulmonary infection in patients with severe fever with thrombocytopenia syndrome: A multicentre observational study

Abstract

Co-infection in patients with severe fever with thrombocytopenia syndrome (SFTS) has been reported, posing a serious threat to survival and treatment. We aimed to systematically investigate the SFTS associated pulmonary infection, particularly invasive pulmonary fungal infection (IPFI). During April 2019 to October 2021, we conducted a multicentre observational study on adult hospitalized patients confirmed with SFTS from three tertiary hospital in central China. Demographic, clinical and laboratory data of patients were collected and re-assessed. A total of 443 patients (51.7% were male sex) were included for analysis with median age of 65-year-old. Among them, 190 (42.9%) patients met the criteria for pulmonary infection. Pulmonary infection was associated with shorter survival time (p < 0.0001 by log-rank test), and adjusted hazard ratio was 1.729 [95% confidence interval, 1.076-2.780] (p = 0.024). Age (odds ratio (OR) 1.040 [1.019-1.062], p < 0.001), time from onset to admission , p < 0.001), having severe status (OR 3.166 [2.020-4.962], p < 0.001) and symptoms of skin change (OR 2.361 [1.049-5.316], p < 0.001) at admission and receiving intravenous immunoglobin ], p = 0.002) were independent risk factors for the occurrence of pulmonary infection. A total of 70 (15.8%) patients were defined as IPFI. Multivariate analysis showed that time from onset to admission ], p = 0.022), severe status .779], p < 0.001), having smoking history .070], p = 0.015) and autoimmunity disease ], p = 0.010), receiving intravenous immunoglobin ], p = 0.005) were independent risk factors for the occurrence of IPFI.In SFTS patients with pulmonary infection, white blood count <2.09 × 10 9 per L .012], p < 0.001) and CD3 + CD4 + T cell count <104.0 per μL .038], p < 0.001) could independently predict IPFI. This study showed the high prevalence and poor outcomes of pulmonary infection and IPFI in

Viral shedding pattern of severe fever with thrombocytopenia syndrome virus in severely ill patients:A Prospective, Multicenter Study

“…It was reported that lung imaging abnormalities was present in 29 to 68.1% of SFTS patients [41]. Pulmonary infection was associated with fatality or increased disease course in SFTS patients [42]. In the present study, SFTSV positive rate of throat swabs in the patients complicating pneumonia were signi cantly higher than patients without pneumonia.…”

Risk factors for invasive pulmonary aspergillosis in patients with severe fever with thrombocytopenia syndrome: A multicenter retrospective study

“…In another large cohort of 2219 SFTS patients, IVIG didn't effectively reduce mortality or improve clinical outcomes 19 . Alarmingly, another study involving 443 SFTS patients linked IVIG to an increased risk of invasive pulmonary fungal infection (IPFI) 20 . One explanation could be the absence of DBV‐specific antibodies in the IVIG preparations.…”

“…18 Alarmingly, another study involving 443 SFTS patients linked IVIG to an increased risk of invasive pulmonary fungal infection (IPFI). 20 One explanation could be the absence of DBV-specific antibodies in the IVIG preparations. As DBV infections are largely localized to specific rural areas, consistently procuring standardized IVIG with DBV-specific antibodies is a hurdle.…”

Viral shedding pattern of severe fever with thrombocytopenia syndrome virus in severely ill patients: A prospective, Multicenter cohort study

“…It was reported that lung imaging abnormalities was present in 29–68.1 % of SFTS patients [ 41 ]. Pulmonary infection was associated with fatality or increased disease course in SFTS patients [ 42 ]. In the present study, SFTSV positive rate of throat swabs in the patients complicating with pneumonia were significantly higher than patients without pneumonia.…”