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Clinical Features and Factors Associated with Severity and Fatality among Patients with Severe Fever with Thrombocytopenia Syndrome Bunyavirus Infection in Northeast China
BACKGROUND: In 2009, severe fever with thrombocytopenia syndrome virus (SFTSV) was identified as a novel member of the genus phlebovirus in the Bunyaviridae family in China. The detailed clinical features of cases with SFTSV infection have not been well described, and the risk factors for severity a...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3827460/ https://www.ncbi.nlm.nih.gov/pubmed/24236203 http://dx.doi.org/10.1371/journal.pone.0080802 |
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author | Deng, Baocheng Zhou, Bo Zhang, Shujun Zhu, Ying Han, Leqiang Geng, Yingzhi Jin, Zhenan Liu, Hongbo Wang, Donglei Zhao, Yitong Wen, Ying Cui, Wei Zhou, Ying Gu, Qiuhong Sun, Cuiming Lu, Xu Wang, Wen Wang, Yu Li, Chengbo Wang, Yanli Yao, Wenqing Liu, Pei |
author_facet | Deng, Baocheng Zhou, Bo Zhang, Shujun Zhu, Ying Han, Leqiang Geng, Yingzhi Jin, Zhenan Liu, Hongbo Wang, Donglei Zhao, Yitong Wen, Ying Cui, Wei Zhou, Ying Gu, Qiuhong Sun, Cuiming Lu, Xu Wang, Wen Wang, Yu Li, Chengbo Wang, Yanli Yao, Wenqing Liu, Pei |
author_sort | Deng, Baocheng |
collection | PubMed |
description | BACKGROUND: In 2009, severe fever with thrombocytopenia syndrome virus (SFTSV) was identified as a novel member of the genus phlebovirus in the Bunyaviridae family in China. The detailed clinical features of cases with SFTSV infection have not been well described, and the risk factors for severity among patients and fatality among severe patients remain to be determined. METHODOLOGY/PRINCIPAL FINDINGS: Clinical and laboratory features of 115 hospitalized patients with SFTSV infection during the period from June 2010 to December 2011 in Northeast China were retrospectively reviewed. We assessed the risk factors associated with severity in confirmed cases and fatality in severe cases by multivariate analysis. One hundred and three (89.6%) of 115 patients presented with multiple organ dysfunction, and 22 (19.1%) of 115 proceeded to the stage of life threatening multiple organ failure. Of the 115 patients, 14 fatalities (12.2%) were reported. Multivariate analysis demonstrated that the independent predictors of risk for severity were: albumin ≤30 g/l (OR, 8.09; 95% CI, 2.58-25.32), APTT ≥ 66 seconds (OR, 14.28; 95% CI, 3.28-62.24), sodium ≤130 mmol/l (OR, 5.44; 95% CI, 1.38-21.40), and presence of neurological manifestations (OR, 7.70; 95% CI, 1.91-31.12). Among patients with severe disease, presence of acute lung injury/acute respiratory distress syndrome (HR, 4.59; 95% CI, 1.48–14.19) and disseminated intravascular coagulation (HR, 4.24; 95% CI, 1.38–13.03) were independently associated with fatality. CONCLUSIONS/SIGNIFICANCE: SFTSV infection may present with more severe symptoms and laboratory abnormalities than hitherto reported. Due to infection with a novel bunyavirus, the patients may sufferer multiple organ dysfunction and die of multiple organ failure. In the clinical assessment of any case of SFTS, independent factors relating to prognosis need to be taken into account by clinicians. |
format | Online Article Text |
id | pubmed-3827460 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-38274602013-11-14 Clinical Features and Factors Associated with Severity and Fatality among Patients with Severe Fever with Thrombocytopenia Syndrome Bunyavirus Infection in Northeast China Deng, Baocheng Zhou, Bo Zhang, Shujun Zhu, Ying Han, Leqiang Geng, Yingzhi Jin, Zhenan Liu, Hongbo Wang, Donglei Zhao, Yitong Wen, Ying Cui, Wei Zhou, Ying Gu, Qiuhong Sun, Cuiming Lu, Xu Wang, Wen Wang, Yu Li, Chengbo Wang, Yanli Yao, Wenqing Liu, Pei PLoS One Research Article BACKGROUND: In 2009, severe fever with thrombocytopenia syndrome virus (SFTSV) was identified as a novel member of the genus phlebovirus in the Bunyaviridae family in China. The detailed clinical features of cases with SFTSV infection have not been well described, and the risk factors for severity among patients and fatality among severe patients remain to be determined. METHODOLOGY/PRINCIPAL FINDINGS: Clinical and laboratory features of 115 hospitalized patients with SFTSV infection during the period from June 2010 to December 2011 in Northeast China were retrospectively reviewed. We assessed the risk factors associated with severity in confirmed cases and fatality in severe cases by multivariate analysis. One hundred and three (89.6%) of 115 patients presented with multiple organ dysfunction, and 22 (19.1%) of 115 proceeded to the stage of life threatening multiple organ failure. Of the 115 patients, 14 fatalities (12.2%) were reported. Multivariate analysis demonstrated that the independent predictors of risk for severity were: albumin ≤30 g/l (OR, 8.09; 95% CI, 2.58-25.32), APTT ≥ 66 seconds (OR, 14.28; 95% CI, 3.28-62.24), sodium ≤130 mmol/l (OR, 5.44; 95% CI, 1.38-21.40), and presence of neurological manifestations (OR, 7.70; 95% CI, 1.91-31.12). Among patients with severe disease, presence of acute lung injury/acute respiratory distress syndrome (HR, 4.59; 95% CI, 1.48–14.19) and disseminated intravascular coagulation (HR, 4.24; 95% CI, 1.38–13.03) were independently associated with fatality. CONCLUSIONS/SIGNIFICANCE: SFTSV infection may present with more severe symptoms and laboratory abnormalities than hitherto reported. Due to infection with a novel bunyavirus, the patients may sufferer multiple organ dysfunction and die of multiple organ failure. In the clinical assessment of any case of SFTS, independent factors relating to prognosis need to be taken into account by clinicians. Public Library of Science 2013-11-13 /pmc/articles/PMC3827460/ /pubmed/24236203 http://dx.doi.org/10.1371/journal.pone.0080802 Text en © 2013 Deng et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Deng, Baocheng Zhou, Bo Zhang, Shujun Zhu, Ying Han, Leqiang Geng, Yingzhi Jin, Zhenan Liu, Hongbo Wang, Donglei Zhao, Yitong Wen, Ying Cui, Wei Zhou, Ying Gu, Qiuhong Sun, Cuiming Lu, Xu Wang, Wen Wang, Yu Li, Chengbo Wang, Yanli Yao, Wenqing Liu, Pei Clinical Features and Factors Associated with Severity and Fatality among Patients with Severe Fever with Thrombocytopenia Syndrome Bunyavirus Infection in Northeast China |
title | Clinical Features and Factors Associated with Severity and Fatality among Patients with Severe Fever with Thrombocytopenia Syndrome Bunyavirus Infection in Northeast China |
title_full | Clinical Features and Factors Associated with Severity and Fatality among Patients with Severe Fever with Thrombocytopenia Syndrome Bunyavirus Infection in Northeast China |
title_fullStr | Clinical Features and Factors Associated with Severity and Fatality among Patients with Severe Fever with Thrombocytopenia Syndrome Bunyavirus Infection in Northeast China |
title_full_unstemmed | Clinical Features and Factors Associated with Severity and Fatality among Patients with Severe Fever with Thrombocytopenia Syndrome Bunyavirus Infection in Northeast China |
title_short | Clinical Features and Factors Associated with Severity and Fatality among Patients with Severe Fever with Thrombocytopenia Syndrome Bunyavirus Infection in Northeast China |
title_sort | clinical features and factors associated with severity and fatality among patients with severe fever with thrombocytopenia syndrome bunyavirus infection in northeast china |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3827460/ https://www.ncbi.nlm.nih.gov/pubmed/24236203 http://dx.doi.org/10.1371/journal.pone.0080802 |
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