Imran Hasanoglu1, Rahmet Guner2, Ahmet Carhan3, Zeliha Kocak Tufan4, Dilek Yagci-Caglayik5, Tumer Guven6, Gul Ruhsar Yilmaz7, Mehmet A Tasyaran8. 1. Ankara Ataturk Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Bilkent, Ankara, Turkey. Electronic address: imran.solak@gmail.com. 2. Yildirim Beyazit University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Bilkent, Ankara, Turkey. Electronic address: rahmetguner@yahoo.com. 3. Department of Medical Biology, Yildirim Beyazit University School of Medicine, Ankara, Turkey. Electronic address: ahmet_carhan@hotmail.com. 4. Department of Infectious Diseases and Clinical Microbiology, Yildirim Beyazit University School of Medicine, Bilkent, Ankara, Turkey. Electronic address: drztufan@yahoo.com. 5. National Arbovirus and Viral Zoonoses Reference and Research Laboratory, Public Health Institute of Turkey, Ankara, Turkey. Electronic address: dilekyagci@gmail.com. 6. Yildirim Beyazit University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Bilkent, Ankara, Turkey. Electronic address: tumerguven@yahoo.com. 7. Ankara Ataturk Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Bilkent, Ankara, Turkey. Electronic address: ruhsar6@yahoo.com. 8. Yildirim Beyazit University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Bilkent, Ankara, Turkey. Electronic address: matasyaran@gmail.com.
Abstract
BACKGROUND: Crimean Congo hemorrhagic fever (CCHF) is a fatal disease with a mortality rate of 5-30%. CCHF can be asymptomatic or it may progress with bleeding and cause mortality. OBJECTIVES: To evaluate relation of viral load with mortality, clinical and laboratory findings in CCHF. STUDY DESIGN: A total of 126 CCHF patients were included. Serum samples obtained from all patients on admission for measurement of viral load. RESULTS: In our study, mortality rate was 11.1%. The most important prognostic factor was viral load. Mean viral load was 8.3×10(7)copy/ml and 4.6×10(9)copy/ml in survived and dead patients, respectively (p<0.005). Probability of survival is found to be significantly reduced where AST >1130U/l, ALT >490U/l, CPK >505U/l, LDH >980U/l, platelet count <23×10(3)/l, creatinine >1.4mg/dl, INR >1.3, d-dimer >7100ng/dl, and viral load >1.03×10(8)copy/ml. Patients with 10(8)copy/ml or higher viral load had diarrhea, headache, unconsciousness, bleeding, and seizure significantly more frequently (p<0.05). WBC, hemoglobin, platelet counts were significantly lower whereas AST, ALT, CPK, LDH, creatinine levels, PT and aPTT time, d-dimer levels, and INR were found to be significantly higher in these group. CONCLUSIONS: There are several severity criteria for prognosis of CCHF. In addition to these parameters, we introduce creatinine as a predictive factor for prognosis. Our study, which has the largest number of patients among studies that evaluate viral load on CCHF shows that viral load is the most effective parameter on mortality.
BACKGROUND:Crimean Congo hemorrhagic fever (CCHF) is a fatal disease with a mortality rate of 5-30%. CCHF can be asymptomatic or it may progress with bleeding and cause mortality. OBJECTIVES: To evaluate relation of viral load with mortality, clinical and laboratory findings in CCHF. STUDY DESIGN: A total of 126 CCHF patients were included. Serum samples obtained from all patients on admission for measurement of viral load. RESULTS: In our study, mortality rate was 11.1%. The most important prognostic factor was viral load. Mean viral load was 8.3×10(7)copy/ml and 4.6×10(9)copy/ml in survived and dead patients, respectively (p<0.005). Probability of survival is found to be significantly reduced where AST >1130U/l, ALT >490U/l, CPK >505U/l, LDH >980U/l, platelet count <23×10(3)/l, creatinine >1.4mg/dl, INR >1.3, d-dimer >7100ng/dl, and viral load >1.03×10(8)copy/ml. Patients with 10(8)copy/ml or higher viral load had diarrhea, headache, unconsciousness, bleeding, and seizure significantly more frequently (p<0.05). WBC, hemoglobin, platelet counts were significantly lower whereas AST, ALT, CPK, LDH, creatinine levels, PT and aPTT time, d-dimer levels, and INR were found to be significantly higher in these group. CONCLUSIONS: There are several severity criteria for prognosis of CCHF. In addition to these parameters, we introduce creatinine as a predictive factor for prognosis. Our study, which has the largest number of patients among studies that evaluate viral load on CCHF shows that viral load is the most effective parameter on mortality.
Authors: Barbara Bartolini; Cesare Em Gruber; Marion Koopmans; Tatjana Avšič; Sylvia Bino; Iva Christova; Roland Grunow; Roger Hewson; Gulay Korukluoglu; Cinthia Menel Lemos; Ali Mirazimi; Anna Papa; Maria Paz Sanchez-Seco; Aisha V Sauer; Hervè Zeller; Carla Nisii; Maria Rosaria Capobianchi; Giuseppe Ippolito; Chantal B Reusken; Antonino Di Caro Journal: Euro Surveill Date: 2019-01
Authors: Gustaf Ahlén; K Sofia Appelberg; Heinz Feldmann; Matti Sällberg; Ali Mirazimi; David W Hawman; Kimberly Meade-White; Patrick W Hanley; Dana Scott; Vanessa Monteil; Stephanie Devignot; Atsushi Okumura; Friedemann Weber Journal: Nat Microbiol Date: 2020-11-30 Impact factor: 17.745
Authors: Ronald B Reisler; Chenggang Yu; Michael J Donofrio; Travis K Warren; Jay B Wells; Kelly S Stuthman; Nicole L Garza; Sean A Vantongeren; Ginger C Donnelly; Christopher D Kane; Mark G Kortepeter; Sina Bavari; Anthony P Cardile Journal: Emerg Infect Dis Date: 2017-08 Impact factor: 6.883