Analysis of Severe Fever With Thrombocytopenia Syndrome in Critical Ill Patients in Central China. Issue 4 (October 2020)

• Record Type: Journal Article
• Authors: Nie, Qi; Wang, Dawei; Ning, Zhijie; Li, Tianmin; Tian, Xinghan; Bian, Pengfei; Ding, Kun; Hu, Chang; Peng, Zhi-Yong
• Is Part Of: Shock. Volume 54:Issue 4(2020)
• Publication Date: 2020-10
• Subjects: Creatinine -- critical illness -- infection -- multiple organ dysfunction syndrome -- severe fever with thrombocytopenia syndrome virus -- Abbreviations -- AKI -- acute kidney injury -- APACHE II -- Acute Physiology and Chronic Health Evaluation II -- ARDS -- acute respiratory distress syndrome -- BUN -- blood urea nitrogen -- CK-MB -- Creatine kinase-MB -- COPD -- chronic obstructive pulmonary disease -- CRRT -- continuous renal replacement therapy -- DIC -- disseminated intravascular coagulation -- GCS -- Glasgow Coma Score -- IQR -- interquartile range -- MODS -- multiple organ dysfunction syndrome -- RT-PCR -- reverse transcriptase polymerase chain reaction -- SFTS -- severe fever with thrombocytopenia syndrome -- SIRS -- systemic inflammatory response syndrome -- SOFA -- sequential organ failure assessment; Shock -- Periodicals; Shock -- Periodicals; Choc (Pathologie) -- Périodiques; Shock; Periodicals; 616.0475
• DOI: 10.1097/SHK.0000000000001527
• Languages: English
• ISSNs: 1073-2322

Abstract

ABSTRACT: Introduction: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging zoonosis infected by virus (SFTSV) in central and eastern China, which is associated with high mortality. However, limited clinical data have been reported about this critical illness. Patients and Methods: Retrospective cohort study in intensive care unit (ICU) patients with SFTSV infection admitted in 2014 to 2019. Diagnosis was confirmed using reverse transcription polymerase chain reaction on serum samples. Results: One hundred sixteen patients with SFTSV infection were included (mean age 63 ± 9 years, 59 [51.3%] males). Non-survivors (43.1%) were older, and had lower Glasgow Coma Score, higher Acute Physiology and Chronic Health Evaluation II, and sequential organ failure assessment score at ICU admission. In addition, non-survivors had more severe respiratory failure (PaO2 /FiO2 : 208 ± 14 mm Hg vs. 297 ± 15 mm Hg), more frequent shock (25[50%] vs. 7[10.6%]), and required more frequently mechanical ventilation (78% vs. 19.7%; P < 0.001) and vasopressor support (56% vs. 9.1%; P < 0.001). Non-survivors experienced more obvious monocyte loss. After adjustment for potential confounding factors, older age, elevated lactate level, and elevated creatinine level were the independent risk factors for death. Conclusion: We provided knowledge about the clinical characteristics of SFTS admitted in ICU. Older age, elevated lactate level, and elevated creatinine level may be useful for identifying patients with poor outcome and intensive medical intervention can be provided for patients as soon as possible to reduce mortality. Abstract : Supplemental Digital Content is available in the text