Clinical efficacy of immunoglobulin on the treatment of severe fever with thrombocytopenia syndrome: a retrospective cohort study

BACKGROUND: Optimal treatment strategy for severe fever with thrombocytopenia syndrome (SFTS) remained unknown. We aimed to evaluate the efficacy of intravenous immunoglobulin (IVIG) on SFTS. METHODS: A retrospective cohort study was conducted based on medical records of the laboratory-confirmed SFT...

Descripción completa

Detalles Bibliográficos
Autores principales: Zhang, Shan-Shan, Du, Juan, Cui, Ning, Yang, Xin, Zhang, Lan, Zhang, Wan-Xue, Yue, Ming, Wu, Yong-Xiang, Yang, Tong, Zhang, Xiao-Ai, Yang, Zhen-Dong, Lv, Hong-Di, Lu, Qing-Bin, Liu, Wei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10520313/
https://www.ncbi.nlm.nih.gov/pubmed/37738834
http://dx.doi.org/10.1016/j.ebiom.2023.104807
_version_ 1785109889987641344
author Zhang, Shan-Shan
Du, Juan
Cui, Ning
Yang, Xin
Zhang, Lan
Zhang, Wan-Xue
Yue, Ming
Wu, Yong-Xiang
Yang, Tong
Zhang, Xiao-Ai
Yang, Zhen-Dong
Lv, Hong-Di
Lu, Qing-Bin
Liu, Wei
author_facet Zhang, Shan-Shan
Du, Juan
Cui, Ning
Yang, Xin
Zhang, Lan
Zhang, Wan-Xue
Yue, Ming
Wu, Yong-Xiang
Yang, Tong
Zhang, Xiao-Ai
Yang, Zhen-Dong
Lv, Hong-Di
Lu, Qing-Bin
Liu, Wei
author_sort Zhang, Shan-Shan
collection PubMed
description BACKGROUND: Optimal treatment strategy for severe fever with thrombocytopenia syndrome (SFTS) remained unknown. We aimed to evaluate the efficacy of intravenous immunoglobulin (IVIG) on SFTS. METHODS: A retrospective cohort study was conducted based on medical records of the laboratory-confirmed SFTS patients hospitalized during 2010–2020 in the 154th hospital, China. A 1:1 propensity score matching with age, sex, the interval from symptom onset to admission, presence of chronic viral hepatitis, diabetes and disease severity was performed between Non-IVIG group (supportive therapy) and IVIG group (IVIG plus supportive therapy). The matching variables were adjusted to compare the case fatality rates (CFRs), viral load and laboratory parameters between the two groups. Risk ratio (RR) and 95% confidence interval (CI) were reported. FINDINGS: Totally 2219 SFTS patients were recruited. CFRs were significantly higher in 1051 patients in IVIG group than 1168 patients in Non-IVIG group (19.0% vs. 4.6%, RR = 4.30, 95% CI 3.12–5.93). The difference remained significant after matching (17.2% vs. 5.1%, RR = 4.02, 95% CI 2.71–5.97). The CFR of IVIG group was significantly higher in all age groups, two IVIG therapy delay groups and two therapy duration groups compared to that of Non-IVIG group (all P < 0.05). IVIG therapy was related to higher viral loads and reduced counts of lymphocytes, T cells, CD4(+) T cells and natural killer cells in the blood (all P < 0.05). INTERPRETATION: No obvious efficacy of IVIG in saving life or improving outcome of SFTS was observed. Caution is needed for clinical physicians to continue prescribing IVIG for SFTS patients. FUNDING: 10.13039/501100001809Natural Science Foundation of China.
format Online
Article
Text
id pubmed-10520313
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-105203132023-09-27 Clinical efficacy of immunoglobulin on the treatment of severe fever with thrombocytopenia syndrome: a retrospective cohort study Zhang, Shan-Shan Du, Juan Cui, Ning Yang, Xin Zhang, Lan Zhang, Wan-Xue Yue, Ming Wu, Yong-Xiang Yang, Tong Zhang, Xiao-Ai Yang, Zhen-Dong Lv, Hong-Di Lu, Qing-Bin Liu, Wei eBioMedicine Articles BACKGROUND: Optimal treatment strategy for severe fever with thrombocytopenia syndrome (SFTS) remained unknown. We aimed to evaluate the efficacy of intravenous immunoglobulin (IVIG) on SFTS. METHODS: A retrospective cohort study was conducted based on medical records of the laboratory-confirmed SFTS patients hospitalized during 2010–2020 in the 154th hospital, China. A 1:1 propensity score matching with age, sex, the interval from symptom onset to admission, presence of chronic viral hepatitis, diabetes and disease severity was performed between Non-IVIG group (supportive therapy) and IVIG group (IVIG plus supportive therapy). The matching variables were adjusted to compare the case fatality rates (CFRs), viral load and laboratory parameters between the two groups. Risk ratio (RR) and 95% confidence interval (CI) were reported. FINDINGS: Totally 2219 SFTS patients were recruited. CFRs were significantly higher in 1051 patients in IVIG group than 1168 patients in Non-IVIG group (19.0% vs. 4.6%, RR = 4.30, 95% CI 3.12–5.93). The difference remained significant after matching (17.2% vs. 5.1%, RR = 4.02, 95% CI 2.71–5.97). The CFR of IVIG group was significantly higher in all age groups, two IVIG therapy delay groups and two therapy duration groups compared to that of Non-IVIG group (all P < 0.05). IVIG therapy was related to higher viral loads and reduced counts of lymphocytes, T cells, CD4(+) T cells and natural killer cells in the blood (all P < 0.05). INTERPRETATION: No obvious efficacy of IVIG in saving life or improving outcome of SFTS was observed. Caution is needed for clinical physicians to continue prescribing IVIG for SFTS patients. FUNDING: 10.13039/501100001809Natural Science Foundation of China. Elsevier 2023-09-20 /pmc/articles/PMC10520313/ /pubmed/37738834 http://dx.doi.org/10.1016/j.ebiom.2023.104807 Text en © 2023 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Articles
Zhang, Shan-Shan
Du, Juan
Cui, Ning
Yang, Xin
Zhang, Lan
Zhang, Wan-Xue
Yue, Ming
Wu, Yong-Xiang
Yang, Tong
Zhang, Xiao-Ai
Yang, Zhen-Dong
Lv, Hong-Di
Lu, Qing-Bin
Liu, Wei
Clinical efficacy of immunoglobulin on the treatment of severe fever with thrombocytopenia syndrome: a retrospective cohort study
title Clinical efficacy of immunoglobulin on the treatment of severe fever with thrombocytopenia syndrome: a retrospective cohort study
title_full Clinical efficacy of immunoglobulin on the treatment of severe fever with thrombocytopenia syndrome: a retrospective cohort study
title_fullStr Clinical efficacy of immunoglobulin on the treatment of severe fever with thrombocytopenia syndrome: a retrospective cohort study
title_full_unstemmed Clinical efficacy of immunoglobulin on the treatment of severe fever with thrombocytopenia syndrome: a retrospective cohort study
title_short Clinical efficacy of immunoglobulin on the treatment of severe fever with thrombocytopenia syndrome: a retrospective cohort study
title_sort clinical efficacy of immunoglobulin on the treatment of severe fever with thrombocytopenia syndrome: a retrospective cohort study
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10520313/
https://www.ncbi.nlm.nih.gov/pubmed/37738834
http://dx.doi.org/10.1016/j.ebiom.2023.104807
work_keys_str_mv AT zhangshanshan clinicalefficacyofimmunoglobulinonthetreatmentofseverefeverwiththrombocytopeniasyndromearetrospectivecohortstudy
AT dujuan clinicalefficacyofimmunoglobulinonthetreatmentofseverefeverwiththrombocytopeniasyndromearetrospectivecohortstudy
AT cuining clinicalefficacyofimmunoglobulinonthetreatmentofseverefeverwiththrombocytopeniasyndromearetrospectivecohortstudy
AT yangxin clinicalefficacyofimmunoglobulinonthetreatmentofseverefeverwiththrombocytopeniasyndromearetrospectivecohortstudy
AT zhanglan clinicalefficacyofimmunoglobulinonthetreatmentofseverefeverwiththrombocytopeniasyndromearetrospectivecohortstudy
AT zhangwanxue clinicalefficacyofimmunoglobulinonthetreatmentofseverefeverwiththrombocytopeniasyndromearetrospectivecohortstudy
AT yueming clinicalefficacyofimmunoglobulinonthetreatmentofseverefeverwiththrombocytopeniasyndromearetrospectivecohortstudy
AT wuyongxiang clinicalefficacyofimmunoglobulinonthetreatmentofseverefeverwiththrombocytopeniasyndromearetrospectivecohortstudy
AT yangtong clinicalefficacyofimmunoglobulinonthetreatmentofseverefeverwiththrombocytopeniasyndromearetrospectivecohortstudy
AT zhangxiaoai clinicalefficacyofimmunoglobulinonthetreatmentofseverefeverwiththrombocytopeniasyndromearetrospectivecohortstudy
AT yangzhendong clinicalefficacyofimmunoglobulinonthetreatmentofseverefeverwiththrombocytopeniasyndromearetrospectivecohortstudy
AT lvhongdi clinicalefficacyofimmunoglobulinonthetreatmentofseverefeverwiththrombocytopeniasyndromearetrospectivecohortstudy
AT luqingbin clinicalefficacyofimmunoglobulinonthetreatmentofseverefeverwiththrombocytopeniasyndromearetrospectivecohortstudy
AT liuwei clinicalefficacyofimmunoglobulinonthetreatmentofseverefeverwiththrombocytopeniasyndromearetrospectivecohortstudy