Department of Internal Medicine, Jeju National University Hospital, Jeju 63241, Korea.
Department of Internal Medicine, College of Medicine and Graduate School of Medicine, Jeju National University, Jeju 63241, Korea.
Viruses. 2020 Dec 23;13(1):10. doi: 10.3390/v13010010.
Severe fever with thrombocytopenia syndrome (SFTS), a tick-borne infectious disease, is difficult to differentiate from other common febrile diseases. Clinically distinctive features and climate variates associated with tick growth can be useful predictors for SFTS. This retrospective study (2013-2019) demonstrated the role of climatic factors as predictors of SFTS and developed a clinical scoring system for SFTS using climate variables and clinical characteristics. The presence of the SFTS virus was confirmed using reverse transcription polymerase chain reaction (RT-PCR) tests. In the univariate analysis, the SFTS-positive group was significantly associated with higher mean ambient temperature and humidity compared with the SFTS-negative group (22.5 °C vs. 18.9 °C; 77.9% vs. 70.7%, all < 0.001). In the multivariate analysis, poor oral intake (Odds ratio [OR] 5.87, 95% CI: 2.42-8.25), lymphadenopathy (OR 7.20, 95% CI: 6.24-11.76), mean ambient temperature ≥ 20 °C (OR 4.62, 95% CI: 1.46-10.28), absolute neutrophil count ≤ 2000 cells/μL (OR 8.95, 95% CI: 2.30-21.25), C-reactive protein level ≤ 1.2 mg/dL (OR 6.42, 95% CI: 4.02-24.21), and creatinine kinase level ≥ 200 IU/L (OR 5.94, 95% CI: 1.42-24.92) were significantly associated with the SFTS-positive group. This study presents the risk factors, including ambient temperature and clinical characteristics, that physicians should consider when suspecting SFTS.
严重发热伴血小板减少综合征（SFTS）是一种蜱传传染病，与其他常见发热性疾病难以区分。临床特征和与蜱虫生长相关的气候变化可作为 SFTS 的有用预测指标。本回顾性研究（2013-2019 年）表明，气候因素可作为 SFTS 的预测指标，并使用气候变量和临床特征开发了 SFTS 的临床评分系统。采用逆转录聚合酶链反应（RT-PCR）检测 SFTS 病毒。单因素分析中，SFTS 阳性组的平均环境温度和湿度显著高于 SFTS 阴性组（22.5°C 比 18.9°C；77.9%比 70.7%，均 < 0.001）。多因素分析中，摄食差（比值比[OR] 5.87，95%置信区间：2.42-8.25）、淋巴结病（OR 7.20，95%置信区间：6.24-11.76）、环境温度≥20°C（OR 4.62，95%置信区间：1.46-10.28）、绝对中性粒细胞计数≤2000 个/μL（OR 8.95，95%置信区间：2.30-21.25）、C 反应蛋白水平≤1.2mg/dL（OR 6.42，95%置信区间：4.02-24.21）和肌酸激酶水平≥200IU/L（OR 5.94，95%置信区间：1.42-24.92）与 SFTS 阳性组显著相关。本研究提出了包括环境温度和临床特征在内的 SFTS 疑似病例中医生应考虑的危险因素。
