Evaluation of Platelet Activity Markers in Prognostic Value of Children with Crimean-Congo Hemorrhagic Fever

2020 ◽  
Vol 15 (03) ◽  
pp. 123-128
Author(s):  
Ahmet Sami Güven ◽  
Fatma Duksal ◽  
Özge Metin Akcan ◽  
Utku Aygüneş ◽  
Mehmet Burhan Oflaz
Keyword(s):  
Disease Severity ◽  
Prognostic Value ◽  
Severe Disease ◽  
Multivariate Logistic Regression Analysis ◽  
Prognostic Index ◽  
Hemorrhagic Fever ◽  
Healthy Children ◽  
Distribution Width ◽  
Crimean Congo Hemorrhagic Fever ◽  
Significant Difference

Abstract Objective The aim of this study is to investigate the prognostic value of platelet (PLT) activity markers in children with Crimean-Congo hemorrhagic fever (CCHF) and compare results with healthy controls. Materials and Methods A total of 135 patients with CCHF and 100 healthy children were included in this retrospective study. Mean age was 12.4 ± 3.3 years in CCHF group, and 92 patients were male. We measured PLT count, mean platelet volume (MPV), platelet distribution width (PDW), and mean platelet mass (MPM) as PLT activity markers. Results A statistically significant decrease in MPM and PLT, and significantly higher levels of PDW and activated partial thromboplastin time (aPTT) and no significant difference in MPV were observed in patients with CCHF compared with controls. Although there were no significant differences between the severe and nonsevere CCHF groups in term of MPV and PDW, the MPM value was significantly decreased in severe patients (p < 0.001). Furthermore, MPM values were inversely correlated with aPTT (r = −0.617, p = 0.015), and positively correlated with PLT (r = 0.703, p < 0.001) which are considered likely to be indicators of disease severity. Multivariate logistic regression analysis revealed MPM as an independent risk factor for severe disease. Conclusion Our study demonstrated that MPM values were decreased in severe cases compared with nonsevere in children with CCHF. The MPM as an indicator of PLT activation at the time of diagnosis in children with CCHF can be used as a prognostic index for disease severity.

scholarly journals Comparison of the Serum Levels of Interferon-α in the Patients With Crimean-Congo Hemorrhagic Fever Based on Disease Severity

2016 ◽  
Vol 1 (2) ◽  
pp. 58-62
Author(s):  
Maliheh Metanat ◽  
Masoud Salehi ◽  
Anita Ale Nabi ◽  
Masoume Noori Jangi ◽  
Alireza Noori Jangi ◽  
...  
Keyword(s):  
Disease Severity ◽  
Hemorrhagic Fever ◽  
Serum Levels ◽  
Interferon Α ◽  
Crimean Congo Hemorrhagic Fever

Diagnostic and prognostic value of Ischemia-modified albumin in patients with Crimean-Congo hemorrhagic fever

2013 ◽  
Vol 85 (4) ◽  
pp. 684-688 ◽  
Author(s):  
Ahmet Mentese ◽  
Iftihar Koksal ◽  
Aysegül Uzun Sumer ◽  
Mustafa Arslan ◽  
S. Caner Karahan ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Hemorrhagic Fever ◽  
Ischemia Modified Albumin ◽  
Crimean Congo Hemorrhagic Fever ◽  
Diagnostic And Prognostic Value

scholarly journals 675. Crimean-Congo Hemorrhagic Fever Beyond Ribavirin: A Systematic Review

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S439-S440
Author(s):  
Stephanie P Fabara ◽  
Raghavendra Tirupathi ◽  
Juan Fernando Ortiz ◽  
Urvish Patel ◽  
Sashwath Srikanth ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
Acute Infection ◽  
Case Series ◽  
Case Fatality ◽  
Hemorrhagic Fever ◽  
The Other ◽  
Duration Of Symptoms ◽  
Crimean Congo Hemorrhagic Fever ◽  
Significant Difference

Abstract Background The Crimean-Congo Hemorrhagic Fever (CCHF) is a tick-borne virus infection that has been reported in about 30 countries worldwide. Clinical presentation is divided into three phases: pre-hemorrhagic, hemorrhagic, and convalescence. Ribavirin is standard of care treatment for acute infection and prophylaxis. However, the use of other treatments beyond ribavirin is largely unknown. Methods We conducted a systematic review using MOOSE protocol. The inclusion and exclusion criteria are seen in the Prisma diagram. For Bias Analysis we use a Robin-1 tool. Literature review algorithm Results We gathered a total of 10 studies, which included 4 therapeutic plasma exchange (TPE), 2 corticosteroids, 2 IVIG, and 1 with convalescent plasma (CP). TPE in one study showed decreased mortality rate and increased efficacy in patients with severe CCHF. While the other study reported pulmonary embolism related to the use of TPE. Nevertheless, the patients had good outcome in the end. Two case reports used TPE plus ribavirin and supportive measures. Both were discharged home and recovered without sequela. Corticosteroids were found to be beneficial in one study were the case fatality rate was lower with the addition of corticosteroids to ribavirin in severely ill patients (p=0.0014). In a case series of six patients, who received the combination in early stages of the disease had good clinical outcomes with improved survival. IVIG was shown to increase platelet counts in two studies. In the first study, platelet count increased above 150,000/mL in 8.5 +/- 2.5 days. While in the other study the normalization of platelets was seen in 4 - 4.8 days, with no significant difference (P = 0.49). In addition, there was a decrease in the duration of symptoms but there was no statistically significant difference in mortality rates (P = 0.171). CP treatment showed a survival rate of 86% in treated patients. CP was more useful in high-risk patients, defined as having a viral load of 108 copies/mL or more. The main limitations of the studies were the sample size and heterogenicity among the outcomes of the studies. Conclusion TPE, CP, IVIG, and corticosteroids were effective in improving the clinical outcomes of the patients. The use of these treatments beyond ribavirin should be explored in future studies. Disclosures All Authors: No reported disclosures

scholarly journals Investigating dizziness symptom in adult cases with Crimean-Congo hemorrhagic fever using various scales

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Adem Bora ◽  
Seyit Ali Büyüktuna ◽  
Kasım Durmuş ◽  
Berat Baturay Demirkıran ◽  
Yasin Aslan ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Disease Severity ◽  
Daily Living ◽  
Clinical Symptoms ◽  
Hemorrhagic Fever ◽  
The Self ◽  
Multicenter Studies ◽  
Pathophysiological Mechanisms ◽  
Crimean Congo Hemorrhagic Fever ◽  
Vestibular Symptoms

Abstract Background This study was to investigate the frequency of self-reported dizziness symptom in cases with Crimean-Congo hemorrhagic fever (CCHF) and the severity of dizziness, if any, by using various scales. The frequency and severity of the self-reported dizziness symptom of CCHF patients, level of disability caused by dizziness, and to what extent vestibular symptoms affected activities of daily living were assessed by various scales. The frequency and severity of the self-reported dizziness symptom of CCHF patients, level of disability caused by dizziness, and to what extent vestibular symptoms affected activities of daily living were assessed by various scales. Results The frequency of dizziness in CCHF cases included in the study was 11.11% and all the cases were involved in the mild category in terms of disease severity. When the results of the scales applied to all of the cases were evaluated in general, it was seen that there was no vertigo or dizziness. Conclusion According to the results of the present study, we consider that multicenter studies with large series investigating pathophysiological mechanisms underlying these clinical symptoms are needed in order to evaluate dizziness symptom and to make definitive interpretations in CCHF disease.

scholarly journals ANTIBODY RESPONSE TO COVID-19 INFECTION- CLINICAL VARIABLES AT PLAY

2020 ◽  
Author(s):  
Anuj Parkash ◽  
Parul Singla ◽  
Meenu Bhatia
Keyword(s):  
Immune Response ◽  
Immune Responses ◽  
Disease Severity ◽  
Statistical Significance ◽  
Severe Disease ◽  
Initial Symptom ◽  
Igg Antibody ◽  
Duration Of Symptoms ◽  
Clinical Variables ◽  
Significant Difference

ABSTRACTBackgroundThe current COVID19 pandemic began in December 2019 and rapidly expanded to become a global pandemic. The COVID 19 presents multitude of clinical disorders, ranges from asymptomatic infection to severe disease, which can accompanied by multisystem failure leading to death. The immune response to SARS CoV 2 is understood to involve all the components of the system that together causes viral elimination and recovery from the infection. However, such immune responses implicated in the disease has varied presentation ranging from mild to a severe form, which appears to hinge on the loss of the immune regulation between protective and altered responses. In this study, we want to unravel this association of immune responses to various clinical variables, which might have a major role to play, while generating the immune response. The objective was to test this hypothesis in our settings and comparing the results of serologic tests from a group of COVID 19 patients and will analyzed the disease severity in comparison.MethodsTesting for SARS COV2 IgG Antibody was done with chemiluminescent assay on the Ortho Clinical Diagnostic’s (OCD) Vitros 5600 platform.ResultsA total of 106 COVID 19 patients were included in this study, of whom 61 were male and 45 were female. Their mean age was 43.7 years (range 17–83) and the median interval between initial symptom onset and sample collection was 12.33 days. Eighty patients (82%) had mild or moderate symptoms and twenty-six patients (18%) had severe symptoms. The antibody titers were positive in 99 patients (93%) and were found negative in 7 patients (7%). When comparing patients with mild/moderate symptoms and patients with severe/critical diseases, no statistically significant difference was observed between their gender ratios (P = 0.373) and age composition (P = 0.224).ConclusionsThe data presented in this research study did not find any statistical significance between SARS CoV 2 IgG antibody levels with COVID 19 disease severity, duration of symptoms, age, gender, and length of convalescence.

Increased Expression Levels Of SOX11 Correlates To Overall Survival and Adds Prognostic Value To The MIPI and MIPI-B Index In a Homogenously Treated Cohort

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 4272-4272
Author(s):  
Lena Nordström ◽  
Venera Kuci ◽  
Sandra Sernbo ◽  
Kirsten Groenbaek ◽  
Arne Kolstad ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Cell Lymphoma ◽  
Risk Group ◽  
International Prognostic Index ◽  
Prognostic Index ◽  
High Dose ◽  
Clinical Protocols ◽  
Ki 67 ◽  
Short Survival ◽  
Significant Difference

Abstract Introduction Mantle cell lymphoma (MCL) is an aggressive B cell lymphoma, previously correlated to a short survival of 3-5 years. Modern clinical protocols, combining immunochemotherapy, high-dose therapy and autologous stem cell transplantation (ASCT) have remarkably improved survival reaching a median survival of more than 10 years. To enable patient stratification, a MCL international prognostic index (MIPI) has been created similar to the international prognostic index (IPI) and follicular lymphoma international prognostic index (FLIPI). However, MIPI alone, or in combination with Ki-67 (MIPI-B), has shown limited use in guiding treatment decisions by poorly separating low and intermediate risk group patients treated with novel clinical protocols. The transcription factor SOX11 has during recent years been shown to be an important diagnostic, prognostic and functional antigen in MCL. We have recently developed a monoclonal antibody to target SOX11 in clinical applications such as IHC and FACS. Using this antibody with improved specificity, we investigated the prognostic use of SOX11 in the homogenously treated Nordic MCL2 and MCL3 cohort. Additionally, we investigated the prognostic value by combining SOX11 and MIPI/MIPI-B. Methods The Nordic MCL2 (n=58) and MCL3 (n=69) patient cohort, treated with first line intensive immunochemotherapy, followed by high-dose chemotherapy and ASCT as well as addition of ibritumomab radioimmunotherapy for MCL3 patients, was stained for SOX11 expression in relation to clinicopathological and biological parameters such as Ki-67, P53 and Cyclin D1. Results In total, 95 % of the Nordic MCL2/3 cohort expressed SOX11, similar to previous studies. The nuclear SOX11 stainings were classified based on both intensity and frequency; negative, weak, strong ≤ 30 % and strong > 30 %. We show that high protein levels of SOX11 (strong > 30 %) correlate to an increased survival among MCL2/3 patients (p=0.02). A positive correlation between SOX11 and Cyclin D1 (p=0.006) was identified while both P53 (p<0.001) and Ki-67 (p=0.008) showed negative correlations. More importantly, we could show that SOX11 adds prognostic value to MIPI by separating the low/intermediate MCL2/3 patient cohort into two groups with a significant difference (p=0.007) in overall survival (OS). Additionally, combining SOX11 and MIPI-B identified a large group of low risk patients with more than 10 years OS. Conclusions We show that the expression level of SOX11 correlates to improved OS in the Nordic MCL2/3 cohort, and this is the first time SOX11 has been correlated to survival in a homogenously treated cohort. Furthermore, the use of SOX11 can separate MIPI low/intermediate patients into two groups with significant difference in OS. SOX11 in combination with MIPI-B defines both a large group of patients with great outcome that benefit from the current treatment and a distinct reduced high risk group of patients with a short survival that potentially should receive alternative treatment. Thus, combining SOX11 status and the MIPI/MIPI-B can be used to stratify patients for treatment selection. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Platelet Distribution Width at First Day of Hospital Admission in Patients with Hemorrhagic Fever with Renal Syndrome Caused by Hantaan Virus May Predict Disease Severity and Critical Patients’ Survival

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Xiude Fan ◽  
Zitong Liu ◽  
Shiqi Fu ◽  
Jiao Sang ◽  
Huan Deng ◽  
...  
Keyword(s):  
Disease Severity ◽  
Characteristic Curve ◽  
Hemorrhagic Fever ◽  
Hantaan Virus ◽  
Platelet Distribution Width ◽  
Distribution Width ◽  
Large Patient ◽  
Large Patient Population ◽  
Critical Patients ◽  
A Prospective Study

Thrombocytopenia is one of the main characteristics of hemorrhagic fever with renal syndrome (HFRS). This study aimed to evaluate the associations of platelet distribution width (PDW) with the disease severity and critical patients’ survival of HFRS. The demographics, clinical data, and white blood cell and platelet parameters including PDW in 260 patients hospitalized for HFRS were analyzed. The results showed that PDW on the first day (PDW1) was positively associated with the disease severity (p=0.005). Multiple regression analysis showed that in addition to age (odds ratio [OR], 1.091; 95% confidence interval [CI], 1.015–1.172) and occurrence of sepsis (OR, 22.283; 95% CI, 2.985–166.325), PDW1 (OR, 0.782; 95% CI, 0.617–0.992) was a risk factor of the mortality, having an area under the receiver operating characteristic curve of 0.709 (95% CI, 0.572–0.846, p=0.013) for predicting mortality, with a sensitivity of 70% and a specificity of 67% at a cutoff of 16.5 fL, in patients with critical HFRS. These results suggest the potential of PDW at the first day of hospitalization as a valuable parameter for evaluating the severity of HFRS and a moderate parameter for predicting the prognosis of critical HFRS patients. A prospective study in large patient population is needed to validate these findings.

scholarly journals Crimean-Congo Hemorrhagic Fever Mouse Model Recapitulating Human Convalescence

2019 ◽  
Vol 93 (18) ◽  
Author(s):  
David W. Hawman ◽  
Kimberly Meade-White ◽  
Elaine Haddock ◽  
Rumi Habib ◽  
Dana Scott ◽  
...  
Keyword(s):  
T Cell ◽  
Mouse Model ◽  
Immune Responses ◽  
Severe Disease ◽  
Small Animal ◽  
T Cell Responses ◽  
Hemorrhagic Fever ◽  
Type I ◽  
Crimean Congo Hemorrhagic Fever ◽  
Cell Responses

ABSTRACT Crimean-Congo hemorrhagic fever virus (CCHFV) is a cause of severe hemorrhagic fever. Its tick reservoir and vector are widely distributed throughout Africa, Southern and Eastern Europe, the Middle East, and Asia. Serological evidence suggests that CCHFV can productively infect a wide variety of species, but only humans develop severe, sometimes fatal disease. The role of the host adaptive immunity in control or contribution to the severe pathology seen in CCHF cases is largely unknown. Studies of adaptive immune responses to CCHFV have been limited due to lack of suitable small animal models. Wild-type mice are resistant to CCHFV infection, and type I interferon-deficient mice typically develop a rapid-onset fatal disease prior to development of adaptive immune responses. We report here a mouse model in which type I interferon-deficient mice infected with a clinical isolate of CCHFV develop a severe inflammatory disease but ultimately recover. Recovery was coincident with development of CCHFV-specific B- and T-cell responses that were sustained for weeks postinfection. We also found that recovery from a primary CCHFV infection could protect against disease following homologous or heterologous reinfection. Together this model enables study of multiple aspects of CCHFV pathogenesis, including convalescence, an important aspect of CCHF disease that existing mouse models have been unsuitable for studying. IMPORTANCE The role of antibody or virus-specific T-cell responses in control of acute Crimean-Congo hemorrhagic fever virus infection is largely unclear. This is a critical gap in our understanding of CCHF, and investigation of convalescence following severe acute CCHF has been limited by the lack of suitable small animal models. We report here a mouse model of CCHF in which infected mice develop severe disease but ultimately recover. Although mice developed an inflammatory immune response along with severe liver and spleen pathology, these mice also developed CCHFV-specific B- and T-cell responses and were protected from reinfection. This model provides a valuable tool to investigate how host immune responses control acute CCHFV infection and how these responses may contribute to the severe disease seen in CCHFV-infected humans in order to develop therapeutic interventions that promote protective immune responses.

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