Announcement

Collapse
No announcement yet.

Clin Infect Dis. Case fatality and effectiveness of ribavirin in hospitalized patients with severe fever with thrombocytopenia syndrome in China

Collapse
X
 
  • Filter
  • Time
  • Show
Clear All
new posts

  • Clin Infect Dis. Case fatality and effectiveness of ribavirin in hospitalized patients with severe fever with thrombocytopenia syndrome in China

    [Source: Clinical Infectious Diseases Journal, full page: (LINK). Abstract, edited.]


    Case fatality and effectiveness of ribavirin in hospitalized patients with severe fever with thrombocytopenia syndrome in China


    Qing-Bin Lu 1,#, Ning Cui 2,#, Hao Li 1,#, Li-Yuan Wang 1,3, Kun Liu 1, Zhen-Dong Yang 2, Bing-Jun Wang 2, Hong-Yu Wang 1,3, Yao-Yun Zhang 1,3, Lu Zhuang 1, Chun-Yan Hu 1, Chun Yuan 2, Xue-Juan Fan 2, Zhen Wang 2, Lan Zhang 2, Xiao-Ai Zhang 1, David H. Walker 4, Wei Liu 1,*, and Wu-Chun Cao 1,*

    Author Affiliations: <SUP>1</SUP>State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, 100071, P. R. China <SUP>2</SUP>The 154 Hospital, People's Liberation Army, Xinyang, 464000, P. R. China <SUP>3</SUP>Graduate School of Anhui Medical University, Hefei, P. R. China <SUP>4</SUP>Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555-0609, USA

    *Correspondence author: Wu-Chun Cao, Ph.D., M.D, Professor and Director, State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 20 Dong-Da Street, Fengtai District; Beijing 100071, P. R. China. Tel: +86-10-63896082, Fax: +86-10-63896082, E-mail: caowc@bmi.ac.cn, Wei Liu, M.D, State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 20 Dong-Da Street, Fengtai District; Beijing 100071, P. R. China. Tel: +86-10-63896082, Fax: +86-10-63896082, E-mail: lwbime@163.com

    # These authors contributed equally to this work.


    Abstract

    Background.

    The wider distribution and high case fatality rate have made severe fever with thrombocytopenia syndrome (SFTS) a significant public health problem. The study is designed to identify the predictors of fatal outcome and to evaluate the effectiveness of antiviral therapy in treating the SFTSV infected patients.


    Method.

    A cross-sectional study was performed in a general hospital located in Xinyang city with largest SFTS patients number during 2011-2012. The primary outcome for the treatment effect analysis was death. Other outcomes included sequential platelet levels, and viral loads observed throughout the hospitalization, and the period in days for platelet count return to normal level after starting ribavirin therapy.


    Results.

    Totally 311 SFTSV infected cases were included in the study. The most frequent clinical presentations were fever, weakness, myalgia and gastrointestinal symptoms. Each patient had both or either of thrombocytopenia and leucopenia. The case fatality ratio (CFR) was 17.4% (95% CI: 13.1%-21.6%). Older age (OR, 1.061, 95%CI, 1.023-1.099, P=0.001), decreased level of consciousness (OR, 5.397, 95%CI, 2.660-10.948, P<0.001), elevated levels of LDH (>1200 U/L) (OR, 2.620, 95%CI, 1.073-6.399, P=0.035 ), and CK (>800 U/L) (OR, 2.328, 95%CI, 1.129-4.800, P=0.022) were significantly associated with fatal outcome. The CFRs were similar between patients who received ribavirin or received no ribavirin therapy. Ribavirin treatment showed no significant effect on either platelet counts or viral loads during the hospitalization in either fatal or non-fatal cases.


    Conclusions.

    These findings can improve the knowledge on the fatal outcome discrimination and the use of antiviral drug for SFTS patients.


    Received April 26, 2013. Accepted August 1, 2013.


    ? The Author 2013. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved.

    For Permissions, please e-mail: journals.permissions@oup.com.


    -
    -------

  • #2
    Re: Undiagnosed Hemorrhagic Disease - China (02): (shandong), Anaplasmosis

    Links to some FT threads on SFTS in China -

    China - Henan/Shangdong Province: Unknown disease kills 31 - 33, possibly a new Bunyavirus carried by ticks Sept - Oct 2010
    New Viral Illness in China Linked to Ticks March 2011
    N Engl J Med. Fever with Thrombocytopenia Associated with a Novel Bunyavirus in China March 2011
    China - 70 cases of Thrombocytopenia syndrome, 4 deaths in 2011 in Henan province May 2011
    China: 2011 SFTS Bunyavirus cases June 2011
    China - Suspected SFTS Bunyavirus outbreak in Henan Province August 2012
    China- SFTS virus appears in Ningbo May 2013
    China - Tick disease outbreak in Henan province causing illness - reportedly a few deaths, many patients June 2013
    Twitter: @RonanKelly13
    The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

    Comment

    Working...
    X