Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei province, China.
Department of Critical Care Medicine, Jinan Infectious Disease Hospital, Shandong University, Jinan, Shandong province, China.
Shock. 2020 Oct;54(4):451-457. doi: 10.1097/SHK.0000000000001527.
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.
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.
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.
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.
严重发热伴血小板减少综合征（SFTS）是一种在中国中部和东部由病毒（SFTSV）感染引起的新发传染病，其死亡率较高。然而，关于这种危重病，报告的临床数据有限。
这是一项对 2014 年至 2019 年期间入住重症监护病房（ICU）的 SFTSV 感染患者进行的回顾性队列研究。通过血清样本的逆转录聚合酶链反应来确认诊断。
共纳入 116 例 SFTSV 感染患者（平均年龄 63±9 岁，59[51.3%]为男性）。非幸存者（43.1%）年龄较大，在入住 ICU 时格拉斯哥昏迷评分较低、急性生理学和慢性健康评估 II 评分较高、序贯器官衰竭评估评分较高。此外，非幸存者呼吸衰竭更严重（PaO2/FiO2：208±14mmHg 比 297±15mmHg）、休克更频繁（25[50%]比 7[10.6%]）、需要更频繁的机械通气（78%比 19.7%；P<0.001）和血管加压素支持（56%比 9.1%；P<0.001）。非幸存者的单核细胞丢失更为明显。在调整了潜在混杂因素后，年龄较大、乳酸水平升高和肌酐水平升高是死亡的独立危险因素。
我们提供了关于 ICU 收治的 SFTS 临床特征的知识。年龄较大、乳酸水平升高和肌酐水平升高可能有助于识别预后不良的患者，以便尽快为患者提供强化医疗干预，降低死亡率。
