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Clinical characteristics and risk factors for severe scrub typhus in pediatric and elderly patients
BACKGROUND: Scrub typhus (ST) is a life-threatening infectious disease if appropriate treatment is unavailable. Large discrepancy of clinical severity of ST patients was reported among age groups, and the underlying risk factors for severe disease are unclear. METHODS: Clinical and epidemiological d...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9053809/ https://www.ncbi.nlm.nih.gov/pubmed/35486642 http://dx.doi.org/10.1371/journal.pntd.0010357 |
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author | Guan, Xiu-Gang Wei, Yue-Hong Jiang, Bao-Gui Zhou, Shi-Xia Zhang, An-Ran Lu, Qing-Bin Zhou, Zi-Wei Chen, Jin-Jin Zhang, Hai-Yang Ji, Yang Yang, Yang Fang, Li-Qun Li, Hao Yang, Zhi-Cong Liu, Wei |
author_facet | Guan, Xiu-Gang Wei, Yue-Hong Jiang, Bao-Gui Zhou, Shi-Xia Zhang, An-Ran Lu, Qing-Bin Zhou, Zi-Wei Chen, Jin-Jin Zhang, Hai-Yang Ji, Yang Yang, Yang Fang, Li-Qun Li, Hao Yang, Zhi-Cong Liu, Wei |
author_sort | Guan, Xiu-Gang |
collection | PubMed |
description | BACKGROUND: Scrub typhus (ST) is a life-threatening infectious disease if appropriate treatment is unavailable. Large discrepancy of clinical severity of ST patients was reported among age groups, and the underlying risk factors for severe disease are unclear. METHODS: Clinical and epidemiological data of ST patients were collected in 55 surveillance hospitals located in Guangzhou City, China, from 2012 to 2018. Severe prognosis and related factors were determined and compared between pediatric and elderly patients. RESULTS: A total of 2,074 ST patients including 209 pediatric patients and 1,865 elderly patients were included, with a comparable disease severity rate of 11.0% (95% CI 7.1%–16.1%) and 10.3% (95% CI 9.0%–11.8%). Different frequencies of clinical characteristics including lymphadenopathy, skin rash, enlarged tonsils, etc. were observed between pediatric and elderly patients. Presence of peripheral edema and decreased hemoglobin were the most important predictors of severe illness in pediatric patients with adjusted ORs by 38.99 (9.96–152.67, p<0.001) and 13.22 (1.54–113.50, p = 0.019), respectively, while presence of dyspnea and increased total bilirubin were the potential determinants of severe disease in elderly patients with adjusted ORs by 11.69 (7.33–18.64, p<0.001) and 3.17 (1.97–5.11, p<0.001), respectively. Compared with pediatric patients, elderly patients were more likely to receive doxycycline (64.8% v.s 9.9%, p<0.001), while less likely to receive azithromycin therapy (5.0% v.s 41.1%, p<0.001). CONCLUSION: The disease severity rate is comparable between pediatric and elderly ST patients, while different clinical features and laboratory indicators were associated with development of severe complications for pediatric and elderly patients, which is helpful for diagnosis and progress assessment of disease for ST patients. |
format | Online Article Text |
id | pubmed-9053809 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-90538092022-04-30 Clinical characteristics and risk factors for severe scrub typhus in pediatric and elderly patients Guan, Xiu-Gang Wei, Yue-Hong Jiang, Bao-Gui Zhou, Shi-Xia Zhang, An-Ran Lu, Qing-Bin Zhou, Zi-Wei Chen, Jin-Jin Zhang, Hai-Yang Ji, Yang Yang, Yang Fang, Li-Qun Li, Hao Yang, Zhi-Cong Liu, Wei PLoS Negl Trop Dis Research Article BACKGROUND: Scrub typhus (ST) is a life-threatening infectious disease if appropriate treatment is unavailable. Large discrepancy of clinical severity of ST patients was reported among age groups, and the underlying risk factors for severe disease are unclear. METHODS: Clinical and epidemiological data of ST patients were collected in 55 surveillance hospitals located in Guangzhou City, China, from 2012 to 2018. Severe prognosis and related factors were determined and compared between pediatric and elderly patients. RESULTS: A total of 2,074 ST patients including 209 pediatric patients and 1,865 elderly patients were included, with a comparable disease severity rate of 11.0% (95% CI 7.1%–16.1%) and 10.3% (95% CI 9.0%–11.8%). Different frequencies of clinical characteristics including lymphadenopathy, skin rash, enlarged tonsils, etc. were observed between pediatric and elderly patients. Presence of peripheral edema and decreased hemoglobin were the most important predictors of severe illness in pediatric patients with adjusted ORs by 38.99 (9.96–152.67, p<0.001) and 13.22 (1.54–113.50, p = 0.019), respectively, while presence of dyspnea and increased total bilirubin were the potential determinants of severe disease in elderly patients with adjusted ORs by 11.69 (7.33–18.64, p<0.001) and 3.17 (1.97–5.11, p<0.001), respectively. Compared with pediatric patients, elderly patients were more likely to receive doxycycline (64.8% v.s 9.9%, p<0.001), while less likely to receive azithromycin therapy (5.0% v.s 41.1%, p<0.001). CONCLUSION: The disease severity rate is comparable between pediatric and elderly ST patients, while different clinical features and laboratory indicators were associated with development of severe complications for pediatric and elderly patients, which is helpful for diagnosis and progress assessment of disease for ST patients. Public Library of Science 2022-04-29 /pmc/articles/PMC9053809/ /pubmed/35486642 http://dx.doi.org/10.1371/journal.pntd.0010357 Text en © 2022 Guan et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://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 Guan, Xiu-Gang Wei, Yue-Hong Jiang, Bao-Gui Zhou, Shi-Xia Zhang, An-Ran Lu, Qing-Bin Zhou, Zi-Wei Chen, Jin-Jin Zhang, Hai-Yang Ji, Yang Yang, Yang Fang, Li-Qun Li, Hao Yang, Zhi-Cong Liu, Wei Clinical characteristics and risk factors for severe scrub typhus in pediatric and elderly patients |
title | Clinical characteristics and risk factors for severe scrub typhus in pediatric and elderly patients |
title_full | Clinical characteristics and risk factors for severe scrub typhus in pediatric and elderly patients |
title_fullStr | Clinical characteristics and risk factors for severe scrub typhus in pediatric and elderly patients |
title_full_unstemmed | Clinical characteristics and risk factors for severe scrub typhus in pediatric and elderly patients |
title_short | Clinical characteristics and risk factors for severe scrub typhus in pediatric and elderly patients |
title_sort | clinical characteristics and risk factors for severe scrub typhus in pediatric and elderly patients |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9053809/ https://www.ncbi.nlm.nih.gov/pubmed/35486642 http://dx.doi.org/10.1371/journal.pntd.0010357 |
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