Lu Wei, Kuang Lin, Hu Yuxing, Shi Jialing, Li Qi, Tian Wen
School of Integrated Chinese and Western Medicine, Hunan University of Chinese Medicine, Changsha, China.
College of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.
Front Microbiol. 2024 Apr 4;15:1329683. doi: 10.3389/fmicb.2024.1329683. eCollection 2024.
Hemorrhagic fever with renal syndrome (HFRS) is an acute infectious disease comprising five stages: fever, hypotension, oliguria, diuresis (polyuria), and convalescence. Increased vascular permeability, coagulopathy, and renal injury are typical clinical features of HFRS, which has a case fatality rate of 1-15%. Despite this, a comprehensive meta-analyses of the clinical characteristics of patients who died from HFRS is lacking.
Eleven Chinese- and English-language research databases were searched, including the China National Knowledge Infrastructure Database, Wanfang Database, SinoMed, VIP Database, PubMed, Embase, Scopus, Cochrane Library, Web of Science, Proquest, and Ovid, up to October 5, 2023. The search focused on clinical features of patients who died from HFRS. The extracted data were analyzed using STATA 14.0.
A total of 37 articles on 140,295 patients with laboratory-confirmed HFRS were included. Categorizing patients into those who died and those who survived, it was found that patients who died were older and more likely to smoke, have hypertension, and have diabetes. Significant differences were also observed in the clinical manifestations of multiple organ dysfunction syndrome, shock, occurrence of overlapping disease courses, cerebral edema, cerebral hemorrhage, toxic encephalopathy, convulsions, arrhythmias, heart failure, dyspnea, acute respiratory distress syndrome, pulmonary infection, liver damage, gastrointestinal bleeding, acute kidney injury, and urine protein levels. Compared to patients who survived, those who died were more likely to demonstrate elevated leukocyte count; decreased platelet count; increased lactate dehydrogenase, alanine aminotransferase, and aspartate aminotransferase levels; prolonged activated partial thromboplastin time and prothrombin time; and low albumin and chloride levels and were more likely to use continuous renal therapy. Interestingly, patients who died received less dialysis and had shorter average length of hospital stay than those who survived.
Older patients and those with histories of smoking, hypertension, diabetes, central nervous system damage, heart damage, liver damage, kidney damage, or multiorgan dysfunction were at a high risk of death. The results can be used to assess patients' clinical presentations and assist with prognostication.https://www.crd.york.ac.uk/prospero/, (CRD42023454553).
肾综合征出血热（HFRS）是一种急性传染病，包括发热、低血压、少尿、多尿（利尿期）和恢复期五个阶段。血管通透性增加、凝血功能障碍和肾损伤是HFRS的典型临床特征，其病死率为1%-15%。尽管如此，目前仍缺乏对死于HFRS患者临床特征的全面荟萃分析。
检索了11个中英文研究数据库，包括中国知网数据库、万方数据库、中国生物医学文献数据库、维普数据库、PubMed、Embase、Scopus、Cochrane图书馆、Web of Science、Proquest和Ovid，检索截止至2023年10月5日。检索重点为死于HFRS患者的临床特征。使用STATA 14.0对提取的数据进行分析。
共纳入37篇关于140,295例实验室确诊HFRS患者的文章。将患者分为死亡组和存活组后发现，死亡患者年龄更大，更有可能吸烟、患有高血压和糖尿病。在多器官功能障碍综合征、休克、重叠病程发生、脑水肿、脑出血、中毒性脑病、抽搐、心律失常、心力衰竭、呼吸困难、急性呼吸窘迫综合征、肺部感染、肝损伤、胃肠道出血、急性肾损伤和尿蛋白水平的临床表现方面也观察到显著差异。与存活患者相比，死亡患者更有可能出现白细胞计数升高；血小板计数降低；乳酸脱氢酶、丙氨酸氨基转移酶和天冬氨酸氨基转移酶水平升高；活化部分凝血活酶时间和凝血酶原时间延长；白蛋白和氯水平降低，并且更有可能接受持续肾脏治疗。有趣的是，死亡患者接受透析的次数较少，平均住院时间比存活患者短。
老年患者以及有吸烟史、高血压、糖尿病、中枢神经系统损伤、心脏损伤、肝损伤、肾损伤或多器官功能障碍史的患者死亡风险较高。这些结果可用于评估患者的临床表现并辅助预后判断。https://www.crd.york.ac.uk/prospero/，（CRD42023454553）
