Chen Keping, Sun Huidi, Geng Yu, Yang Chuankun, Shan Chun, Chen Yuxin
Clinical Laboratory, Zhongda Hospital, Medical School, Southeast University, Nanjing, China.
Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
Front Microbiol. 2023 Apr 18;14:1168381. doi: 10.3389/fmicb.2023.1168381. eCollection 2023.
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease with high mortality. The pathophysiology of SFTS remains unclear. Hence, the identification of inflammatory biomarkers for SFTS is crucial for the timely management and prevention of disease severity.
A total of 256 patients with SFTS were divided into a survivor group and a non-survivor group. Classical inflammatory biomarkers such as ferritin, procalcitonin (PCT), C-reactive protein (CRP), and white blood cells were investigated for their association with viral load and the clinical significance for predicting the mortality of patients with SFTS.
Serum ferritin and PCT showed a positive association with viral load. Ferritin and PCT levels in non-survivors were significantly higher than those in survivors at 7-9 days from symptom onset. The area under the receiver operating characteristic curve (AUC) values of ferritin and PCT for predicting the fatal outcome of SFTS were 0.9057 and 0.8058, respectively. However, the CRP levels and WBC counts exhibited a weak association with viral load. The AUC value of CRP for predicting mortality was more than 0.7 at 13-15 days from symptom onset.
Ferritin and PCT levels, especially ferritin, could be potential inflammatory biomarkers for predicting the prognosis of patients with SFTS in its early stages.
发热伴血小板减少综合征(SFTS)是一种新出现的具有高死亡率的传染病。SFTS的病理生理学仍不清楚。因此,确定SFTS的炎症生物标志物对于疾病严重程度的及时管理和预防至关重要。
总共256例SFTS患者被分为存活组和非存活组。研究了铁蛋白、降钙素原(PCT)、C反应蛋白(CRP)和白细胞等经典炎症生物标志物与病毒载量的相关性以及对预测SFTS患者死亡率的临床意义。
血清铁蛋白和PCT与病毒载量呈正相关。在症状出现后7 - 9天,非存活者的铁蛋白和PCT水平显著高于存活者。铁蛋白和PCT预测SFTS致命结局的受试者工作特征曲线(AUC)值分别为0.9057和0.8058。然而,CRP水平和白细胞计数与病毒载量的相关性较弱。在症状出现后13 - 15天,CRP预测死亡率的AUC值大于0.7。
铁蛋白和PCT水平,尤其是铁蛋白,可能是预测SFTS患者早期预后的潜在炎症生物标志物。