Department of Infectious Diseases and Clinical Microbiology, Ministry of Health Ankara City Hospital, Ankara, Turkey.
Department of Infectious Diseases and Clinical Microbiology, Health Science University Turkey, Ankara City Hospital, Ankara, Turkey.
Vector Borne Zoonotic Dis. 2022 Sep;22(9):465-471. doi: 10.1089/vbz.2022.0007. Epub 2022 Aug 24.
Crimean-Congo hemorrhagic fever CCHF) is an emerging infectious disease that has epidemic and pandemic potential and causes mortality. Predicting the outcome of the disease is important to guide the management of patients and prevent mortality. This study aimed to investigate hemogram parameters and hemogram-derived ratios for predicting mortality in 207 patients with CCHF (survivors = 177, nonsurvivors = 30). Compared with the survivor group, the nonsurvivor group had higher neutrophils, neutrophil-to-lymphocyte ratio (NLR), derived NLR (d-NLR), and aspartate aminotransferase (AST), AST-to-lymphocyte ratio index (ALRI) on admission and third day of hospitalization. Higher white blood cells (WBCs), lower platelet-to-lymphocyte ratio on admission, and lower lymphocytes, and monocytes on the third day were found in the nonsurvivor group. Evaluating the change of admission and the third day of laboratory values, a downward trend in neutrophils, NLR, d-NLR, ALRI, and an upward trend in WBCs were found statistically significant in the survivor group. These dynamic changes were not found in the nonsurvivor group. AST (third day) and ALRI (third day) had the highest area under the curve (AUC) in the receiver operating characteristic analysis (0.939 and 0.934, respectively; -value is <0.0001 for all). The NLR on the third day than on admission had a higher AUC, the optimal cutoff value was 1.44, which resulted in a sensitivity of 93.33 and a specificity of 40.34 (AUC: 0.790, < 0.0001). The d-NLR on the third day had a higher AUC (with a sensitivity of 81.48 and a specificity of 67.43) than on admission (0.781 and 0.669, respectively). CCHF is a common vector-borne disease and mortality rates are high. This study revealed that NLR, d-NLR, and ALRI can be used as biomarkers to predict mortality. Patients who survived had better improvement in hemogram parameters and ratios. Therefore, patients who do not show this improvement should be followed more closely.
克里米亚-刚果出血热（CCHF）是一种具有流行和大流行潜力并导致死亡的新发传染病。预测疾病的结果对于指导患者的管理和预防死亡很重要。本研究旨在调查血象参数和血象衍生比值，以预测 207 例 CCHF 患者的死亡率（幸存者=177，非幸存者=30）。与幸存者组相比，非幸存者组在入院和住院第 3 天的中性粒细胞、中性粒细胞与淋巴细胞比值（NLR）、衍生 NLR（d-NLR）和天冬氨酸转氨酶（AST）、AST 与淋巴细胞比值指数（ALRI）较高。非幸存者组入院时白细胞（WBC）较高，血小板与淋巴细胞比值较低，第 3 天淋巴细胞和单核细胞较低。在非幸存者组中未发现入院时和第 3 天实验室值的评估，在幸存者组中发现中性粒细胞、NLR、d-NLR、ALRI 呈下降趋势，WBC 呈上升趋势，具有统计学意义。在非幸存者组中未发现这些动态变化。在接受者操作特征分析中，AST（第 3 天）和 ALRI（第 3 天）的曲线下面积（AUC）最高（分别为 0.939 和 0.934；所有值的 P 值均<0.0001）。入院时 NLR 高于第 3 天，AUC 值更高，最佳截断值为 1.44，其灵敏度为 93.33，特异性为 40.34（AUC：0.790，<0.0001）。第 3 天的 d-NLR 比入院时具有更高的 AUC（灵敏度为 81.48，特异性为 67.43），而入院时的 AUC 分别为 0.781 和 0.669。CCHF 是一种常见的虫媒传染病，死亡率很高。本研究表明，NLR、d-NLR 和 ALRI 可作为预测死亡率的生物标志物。存活的患者血象参数和比值改善更好。因此，未显示出这种改善的患者应更密切地监测。
