Analysis of clinical characteristics and death risk factors in patients infected with severe fever with thrombocytopenia syndrome bunyavirus / 中国医师进修杂志

ABSTRACT

Objective The study the clinical characteristics and death risk factors in patients infected with severe fever with thrombocytopenia syndrome bunyavirus (SFTSV). Methods The clinical data of 56 patients infected with SFTSV from May 2011 to October 2016 were retrospectively analyzed. The clinical characteristics and laboratory examination results were compared between cured patients and death patients. The death risk factors were analyzed by two classification Logistic regression analysis. Results Among the 56 cases, 40 cases were cured and 16 cases were dead, and the time of onset to death was (12 ± 3) d. All patients showed symptoms including fever and weakness. Bone marrow biopsy was performed in 26 cases, and hemophagocytic phenomenon was found in 21 cases. Compared with cured patients, the death patients were older; the rate of underlying diseases was higher; fever time was longer; the incidences of skin and/ or gastrointestinal bleeding, neuropsychiatric symptoms, abnormal troponin and arrhythmias were higher, platelet, CD4+and CD8+were lower; the levels of activated partial thromboplastin time (APTT), creatine kinase (CK), lactate dehydrogenase (LDH), viral load, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were higher, and there were statistical differences (P＜0.01 or ＜0.05). Two classification Logistic regression analysis result showed that viral load ≥ 5 lgTCID50/ml, age ≥ 70 years, platelet ＜ 20 × 109/L, CK ＞ 1 200 U/L, fever time ＞ 8 d, APTT ≥ 120 s, troponin elevation and neuropsychiatric symptoms were the independent risk factors of death in patients infected with SFTSV (P＜0.01 or＜0.05). Conclusions The high viral load, high age, lower platelet, increased CK, prolonged fever time and APTT, elevated troponin and neuropsychiatric symptoms were independent risk factors of death in patients infected with SFTSV. Early identification for the risk factors of death may improve the prognosis.