Risk Factors and Clinical Characteristics of Severe Fever with Thrombocytopenia Syndrome

Abstract

This study was to investigate the clinical characteristics and laboratory parameters of severe fever with thrombocytopenia syndrome (SFTS). Patients and Methods: A detailed retrospective analysis of clinical records for SFTS patients was conducted. Fifty-one cases confirmed SFTS virus infected were enrolled. The clinical characteristics and laboratory parameters between survivors and non-survivors were analyzed. Results: All patients aged between 30 and 80 years were farmers or residing in wooded and hilly areas. All patients occurred between April and October. The major clinical manifestations were fever, fatigue, diarrhea, myalgia, nausea and vomiting. Conscious disturbance, lymph node enlargement and hemorrhage were common. Fatal outcome occurred in 31.4% (16/51) of patients. Compared with survivors group, in non-survivors group, the proportion of consciousness disturbance, age, the levels of AST, LDH, Bun, Cr, PT and APTT were significantly increased, and PLT was significantly decreased. The age, PLT, AST, LDH, Cr, PT and APTT were the risk factors for fatal outcomes. Moreover, the age (OR, 1.245; 95% CI, 1.052-1.474) and APTT (OR, 1.095; 95% CI, 1.005-1.192) were the independent risk factors for fatal outcomes. Heteromorphic lymphocyte and hemophagocytosis could be found in SFTS patients, especially the proportion of finding hemophagocytosis was significantly higher in non-survivors group compared with survivors group. Conclusion:These results suggest SFTS is a systemic infection, the age and APTT can be used as potential predictors referring to severe SFTS cases.

Clinical laboratory parameters and fatality of Severe fever with thrombocytopenia syndrome patients: A systematic review and meta-analysis

“…Our study suggested that the elevated levels of indexes above significantly increased mortality risk of SFTS patients. Previous studies [ 41 , 58 ] demonstrated that the measurement indicative of pathological lesions mainly involved the hematological system, liver, kidney, muscle and lymphoid system in different stage, indicating acute inflammation and impairment of liver and renal function is present at an early phase of the illness, corroborating the notion that SFTS is a complicated multisystem disease. Liver and renal function parameters were identified as the critical predictors of fatal outcome because they were confirmed to be the major target organ in SFTSV infected animal model [ 54 ].…”

“…67.65% (23/34) of studies enrolled participants just from one hospital. Patient inclusion criteria varied across studies: most studies included all SFTS patients [ 16 , 18 – 23 , 25 , 28 – 30 , 32 – 35 , 37 , 40 – 48 ], whereas others had strict enrolment criteria. For example, SFTS cases were excluded if they had a history of serious chronic diseases or they were coinfected by other viruses in some studies [ 15 , 17 , 24 , 26 , 36 , 39 ].…”

Predictive Value of the Platelet-to-Albumin Ratio (PAR) on the Risk of Death at Admission in Patients Suffering from Severe Fever with Thrombocytopenia Syndrome

“…12 Additionally, past investigations on the prognostic worth of PAR showed that the preoperative PAR was significantly associated with the patients' prognoses in pancreatic adenocarcinomas and non-small cell lung carcinomas. 9,10 A few previous studies have reported all cases that occurred between April and October, 14,17 This is consistent with our conclusions, that after grouping by year and quarter, it can be observed that the main infection time distribution was primarily found in the second and third quarters (Figure 1). The mean age of all patients was 62.3 years.…”

“…Meanwhile, our data also showed that age and BUN could serve as an independent risk factor for fatal outcomes, which was consistent with most of the previous studies. 17,19 We further investigated the possible predictive effect of PAR as an independent predictor of mortality in adult patients with SFTS. The survival group displayed a significantly a higher PAR value than the death group.…”

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

“…Second, the transmission of host-virus for the disease is currently unknown, but previous clinical reports show that most patients with SFTS have tick bites. [ 20 ] 21.27% of patients had definite tick bites, indicating that ticks may be one of the main vectors of SFTSV, but most patients did not have tick bites within 2 weeks, suggesting that there may be other vectors temporarily unidentified in the region. Most patients are farmers, and the diseases are between April and November, which are the same as the reports in the literature.…”