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Preexisting chronic conditions for fatal outcome among SFTS patients: An observational Cohort Study
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease that is caused by a novel bunyavirus SFTSV. Currently our knowledge of the host-related factors that influence the pathogenesis of disease is inadequate to allow prediction of fatal outcome. Here we conducted a pros...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6555536/ https://www.ncbi.nlm.nih.gov/pubmed/31136581 http://dx.doi.org/10.1371/journal.pntd.0007434 |
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author | Zhang, Shao-Fei Yang, Zhen-Dong Huang, Mao-Lin Wang, Zhi-Bo Hu, Yuan-Yuan Miao, Dong Dai, Ke Du, Juan Cui, Ning Yuan, Chun Li, Hao Li, Xiao-Kun Zhang, Xiao-Ai Zhang, Pan-He Mi, Xian-Miao Lu, Qing-Bin Liu, Wei |
author_facet | Zhang, Shao-Fei Yang, Zhen-Dong Huang, Mao-Lin Wang, Zhi-Bo Hu, Yuan-Yuan Miao, Dong Dai, Ke Du, Juan Cui, Ning Yuan, Chun Li, Hao Li, Xiao-Kun Zhang, Xiao-Ai Zhang, Pan-He Mi, Xian-Miao Lu, Qing-Bin Liu, Wei |
author_sort | Zhang, Shao-Fei |
collection | PubMed |
description | Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease that is caused by a novel bunyavirus SFTSV. Currently our knowledge of the host-related factors that influence the pathogenesis of disease is inadequate to allow prediction of fatal outcome. Here we conducted a prospective study of the largest database on the SFTS patients, to identify the presence of comorbidities in SFTS, and estimate their effect on the fatal outcome. Among 2096 patients eligible for inclusion, we identified nine kinds of comorbidities, from which hyperlipidemia (12.2%; 95% CI: 10.8%–13.6%), hypertension (11.0%; 95% CI: 9.6%–12.3%), chronic viral hepatitis (CVH) (9.3%; 95% CI: 8.1%–10.5%), and diabetes mellitus (DM) (6.8%; 95% CI: 5.7%–7.9%) were prevalent. Higher risk of death was found in patients with DM (adjusted OR = 2.304; 95% CI: 1.520–3.492; P<0.001), CVH (adjusted OR = 1.551; 95% CI: 1.053–2.285; P = 0.026) and chronic obstructive pulmonary diseases (COPD) (adjusted OR = 2.170; 95% CI: 1.215–3.872; P = 0.009) after adjusting for age, sex, delay from disease onset to admission and treatment regimens. When analyzing the comorbidities separately, we found that the high serum glucose could augment diseases severity. Compared to the group with max glucose < 7.0 mmol/L, patients with glucose between 7.0–11.1 mmol/L and glucose ≥11.1 mmol/L conferred higher death risk, with the adjusted OR to be 1.467 (95% CI: 1.081–1.989; P = 0.014) and 3.443 (95% CI: 2.427–4.884; P<0.001). Insulin therapy could effectively reduce the risk of severe outcome in DM patients with the adjusted OR 0.146 (95% CI: 0.058–0.365; P<0.001). For CVH patients, severe damage of liver and prolongation of blood coagulation time, as well as high prevalence of bleeding phenotype were observed. These data supported the provocative hypothesis that treating SFTS related complications can attain potentially beneficial effects on SFTS. |
format | Online Article Text |
id | pubmed-6555536 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-65555362019-06-17 Preexisting chronic conditions for fatal outcome among SFTS patients: An observational Cohort Study Zhang, Shao-Fei Yang, Zhen-Dong Huang, Mao-Lin Wang, Zhi-Bo Hu, Yuan-Yuan Miao, Dong Dai, Ke Du, Juan Cui, Ning Yuan, Chun Li, Hao Li, Xiao-Kun Zhang, Xiao-Ai Zhang, Pan-He Mi, Xian-Miao Lu, Qing-Bin Liu, Wei PLoS Negl Trop Dis Research Article Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease that is caused by a novel bunyavirus SFTSV. Currently our knowledge of the host-related factors that influence the pathogenesis of disease is inadequate to allow prediction of fatal outcome. Here we conducted a prospective study of the largest database on the SFTS patients, to identify the presence of comorbidities in SFTS, and estimate their effect on the fatal outcome. Among 2096 patients eligible for inclusion, we identified nine kinds of comorbidities, from which hyperlipidemia (12.2%; 95% CI: 10.8%–13.6%), hypertension (11.0%; 95% CI: 9.6%–12.3%), chronic viral hepatitis (CVH) (9.3%; 95% CI: 8.1%–10.5%), and diabetes mellitus (DM) (6.8%; 95% CI: 5.7%–7.9%) were prevalent. Higher risk of death was found in patients with DM (adjusted OR = 2.304; 95% CI: 1.520–3.492; P<0.001), CVH (adjusted OR = 1.551; 95% CI: 1.053–2.285; P = 0.026) and chronic obstructive pulmonary diseases (COPD) (adjusted OR = 2.170; 95% CI: 1.215–3.872; P = 0.009) after adjusting for age, sex, delay from disease onset to admission and treatment regimens. When analyzing the comorbidities separately, we found that the high serum glucose could augment diseases severity. Compared to the group with max glucose < 7.0 mmol/L, patients with glucose between 7.0–11.1 mmol/L and glucose ≥11.1 mmol/L conferred higher death risk, with the adjusted OR to be 1.467 (95% CI: 1.081–1.989; P = 0.014) and 3.443 (95% CI: 2.427–4.884; P<0.001). Insulin therapy could effectively reduce the risk of severe outcome in DM patients with the adjusted OR 0.146 (95% CI: 0.058–0.365; P<0.001). For CVH patients, severe damage of liver and prolongation of blood coagulation time, as well as high prevalence of bleeding phenotype were observed. These data supported the provocative hypothesis that treating SFTS related complications can attain potentially beneficial effects on SFTS. Public Library of Science 2019-05-28 /pmc/articles/PMC6555536/ /pubmed/31136581 http://dx.doi.org/10.1371/journal.pntd.0007434 Text en © 2019 Zhang 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 (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Zhang, Shao-Fei Yang, Zhen-Dong Huang, Mao-Lin Wang, Zhi-Bo Hu, Yuan-Yuan Miao, Dong Dai, Ke Du, Juan Cui, Ning Yuan, Chun Li, Hao Li, Xiao-Kun Zhang, Xiao-Ai Zhang, Pan-He Mi, Xian-Miao Lu, Qing-Bin Liu, Wei Preexisting chronic conditions for fatal outcome among SFTS patients: An observational Cohort Study |
title | Preexisting chronic conditions for fatal outcome among SFTS patients: An observational Cohort Study |
title_full | Preexisting chronic conditions for fatal outcome among SFTS patients: An observational Cohort Study |
title_fullStr | Preexisting chronic conditions for fatal outcome among SFTS patients: An observational Cohort Study |
title_full_unstemmed | Preexisting chronic conditions for fatal outcome among SFTS patients: An observational Cohort Study |
title_short | Preexisting chronic conditions for fatal outcome among SFTS patients: An observational Cohort Study |
title_sort | preexisting chronic conditions for fatal outcome among sfts patients: an observational cohort study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6555536/ https://www.ncbi.nlm.nih.gov/pubmed/31136581 http://dx.doi.org/10.1371/journal.pntd.0007434 |
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