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Corticosteroids May Have Negative Effects on the Management of Patients with Severe Fever with Thrombocytopenia Syndrome: A Case–Control Study

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging viral hemorrhagic fever in China, Korea, and Japan. To date, no standardized treatment protocol for SFTS has been established. Corticosteroids (CS) may be administered to patients with SFTS and hemophagocytic syndrome, but its effecti...

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Autores principales: Kawaguchi, Takeshi, Umekita, Kunihiko, Yamanaka, Atsushi, Hara, Seiichiro, Yamaguchi, Tetsuro, Inoue, Eisuke, Okayama, Akihiko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8145003/
https://www.ncbi.nlm.nih.gov/pubmed/33925061
http://dx.doi.org/10.3390/v13050785
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author Kawaguchi, Takeshi
Umekita, Kunihiko
Yamanaka, Atsushi
Hara, Seiichiro
Yamaguchi, Tetsuro
Inoue, Eisuke
Okayama, Akihiko
author_facet Kawaguchi, Takeshi
Umekita, Kunihiko
Yamanaka, Atsushi
Hara, Seiichiro
Yamaguchi, Tetsuro
Inoue, Eisuke
Okayama, Akihiko
author_sort Kawaguchi, Takeshi
collection PubMed
description Severe fever with thrombocytopenia syndrome (SFTS) is an emerging viral hemorrhagic fever in China, Korea, and Japan. To date, no standardized treatment protocol for SFTS has been established. Corticosteroids (CS) may be administered to patients with SFTS and hemophagocytic syndrome, but its effectiveness and safety are still debatable. We conducted a retrospective case series review at four medical facilities in Miyazaki, Japan. Based on the medical records, clinical data, including the patients background, symptoms, physical findings, laboratory data at initial presentation, treatment, and outcome, were compared between the CS-treated and the non-CS-treated group. A total of 47 patients with confirmed SFTS in each hospital were enrolled in this study; there were 14 fatal cases and 33 nonfatal cases. The case fatality ratio was 29.8%. After adjusting patients’ background by propensity score matching, the case fatality ratio was higher (p = 0.04) and complications of secondary infections, including invasive pulmonary aspergillosis, tended to be more frequent (p = 0.07) in the CS-treated group than in the non-CS-treated group. These data suggested that administration of CS to patients with SFTS should be carefully considered.
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spelling pubmed-81450032021-05-26 Corticosteroids May Have Negative Effects on the Management of Patients with Severe Fever with Thrombocytopenia Syndrome: A Case–Control Study Kawaguchi, Takeshi Umekita, Kunihiko Yamanaka, Atsushi Hara, Seiichiro Yamaguchi, Tetsuro Inoue, Eisuke Okayama, Akihiko Viruses Article Severe fever with thrombocytopenia syndrome (SFTS) is an emerging viral hemorrhagic fever in China, Korea, and Japan. To date, no standardized treatment protocol for SFTS has been established. Corticosteroids (CS) may be administered to patients with SFTS and hemophagocytic syndrome, but its effectiveness and safety are still debatable. We conducted a retrospective case series review at four medical facilities in Miyazaki, Japan. Based on the medical records, clinical data, including the patients background, symptoms, physical findings, laboratory data at initial presentation, treatment, and outcome, were compared between the CS-treated and the non-CS-treated group. A total of 47 patients with confirmed SFTS in each hospital were enrolled in this study; there were 14 fatal cases and 33 nonfatal cases. The case fatality ratio was 29.8%. After adjusting patients’ background by propensity score matching, the case fatality ratio was higher (p = 0.04) and complications of secondary infections, including invasive pulmonary aspergillosis, tended to be more frequent (p = 0.07) in the CS-treated group than in the non-CS-treated group. These data suggested that administration of CS to patients with SFTS should be carefully considered. MDPI 2021-04-28 /pmc/articles/PMC8145003/ /pubmed/33925061 http://dx.doi.org/10.3390/v13050785 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kawaguchi, Takeshi
Umekita, Kunihiko
Yamanaka, Atsushi
Hara, Seiichiro
Yamaguchi, Tetsuro
Inoue, Eisuke
Okayama, Akihiko
Corticosteroids May Have Negative Effects on the Management of Patients with Severe Fever with Thrombocytopenia Syndrome: A Case–Control Study
title Corticosteroids May Have Negative Effects on the Management of Patients with Severe Fever with Thrombocytopenia Syndrome: A Case–Control Study
title_full Corticosteroids May Have Negative Effects on the Management of Patients with Severe Fever with Thrombocytopenia Syndrome: A Case–Control Study
title_fullStr Corticosteroids May Have Negative Effects on the Management of Patients with Severe Fever with Thrombocytopenia Syndrome: A Case–Control Study
title_full_unstemmed Corticosteroids May Have Negative Effects on the Management of Patients with Severe Fever with Thrombocytopenia Syndrome: A Case–Control Study
title_short Corticosteroids May Have Negative Effects on the Management of Patients with Severe Fever with Thrombocytopenia Syndrome: A Case–Control Study
title_sort corticosteroids may have negative effects on the management of patients with severe fever with thrombocytopenia syndrome: a case–control study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8145003/
https://www.ncbi.nlm.nih.gov/pubmed/33925061
http://dx.doi.org/10.3390/v13050785
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