Departamento de Paciente Crítico, Clínica Alemana de Santiago, Santiago 7650567, Chile.
Escuela de Medicina. Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago 7710162, Chile.
Viruses. 2019 Jul 30;11(8):693. doi: 10.3390/v11080693.
Hantavirus cardiopulmonary syndrome (HCPS) has a mortality up to 35-40% and its treatment is mainly supportive. A variable to predict progression from mild to severe disease is unavailable. This study was performed in patients with documented infection by Andes orthohantavirus, and the aim was to find a simple variable to predict progression to moderate/severe HCPS in patients with mild disease at admission.
We performed a retrospective analysis of 175 patients between 2001 and 2018. Patients were categorized into mild, moderate, and severe disease according to organ failure and advanced support need at hospital admission (e.g., mechanical ventilation, vasopressors). Progression to moderate/severe disease was defined accordingly. Clinical and laboratory variables associated with progression were explored.
Forty patients with mild disease were identified; 14 of them progressed to moderate/severe disease. Only platelet count was different between those who progressed versus those that did not (37 (34-58) vs. 83 (64-177) K/mm, < 0.001). A ROC curve analysis showed an AUC = 0.889 (0.78-1.0) < 0.001, with a platelet count greater than 115K /mm ruling out progression to moderate/severe disease.
In patients with mild disease at presentation, platelet count could help to define priority of evacuation to tertiary care centers.
汉坦病毒心肺综合征（HCPS）的死亡率高达 35-40%，其治疗主要为支持性治疗。目前还没有可以预测轻症向重症进展的指标。本研究纳入了已确诊感染安第斯 orthohantavirus 的患者，旨在寻找一种简单的变量，以预测轻症患者入院时病情进展为中/重度 HCPS。
我们对 2001 年至 2018 年间的 175 例患者进行了回顾性分析。根据入院时器官衰竭和高级支持需求（例如机械通气、升压药），将患者分为轻症、中症和重症。相应地将进展到中/重度疾病定义为进展。探讨与疾病进展相关的临床和实验室变量。
确定了 40 例轻症患者，其中 14 例进展为中/重度疾病。仅血小板计数在进展组和未进展组之间存在差异（37（34-58） vs. 83（64-177） K/mm， < 0.001）。ROC 曲线分析显示 AUC = 0.889（0.78-1.0） < 0.001，血小板计数大于 115 K /mm 可排除进展为中/重度疾病。
在入院时表现为轻症的患者中，血小板计数有助于确定向三级护理中心转移的优先级。
