Clinical efficacy of immunoglobulin on the treatment of severe fever with thrombocytopenia syndrome: a retrospective cohort studyResearch in context
Summary: Background: Optimal treatment strategy for severe fever with thrombocytopenia syndrome (SFTS) remained unknown. We aimed to evaluate the efficacy of intravenous immunoglobulin (IVIG) on SFTS. Methods: A retrospective cohort study was conducted based on medical records of the laboratory-con...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-10-01
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| Series: | EBioMedicine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352396423003730 |
| _version_ | 1827810059646664704 |
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| author | Shan-Shan Zhang Juan Du Ning Cui Xin Yang Lan Zhang Wan-Xue Zhang Ming Yue Yong-Xiang Wu Tong Yang Xiao-Ai Zhang Zhen-Dong Yang Hong-Di Lv Qing-Bin Lu Wei Liu |
| author_facet | Shan-Shan Zhang Juan Du Ning Cui Xin Yang Lan Zhang Wan-Xue Zhang Ming Yue Yong-Xiang Wu Tong Yang Xiao-Ai Zhang Zhen-Dong Yang Hong-Di Lv Qing-Bin Lu Wei Liu |
| author_sort | Shan-Shan Zhang |
| collection | DOAJ |
| description | Summary: Background: Optimal treatment strategy for severe fever with thrombocytopenia syndrome (SFTS) remained unknown. We aimed to evaluate the efficacy of intravenous immunoglobulin (IVIG) on SFTS. Methods: A retrospective cohort study was conducted based on medical records of the laboratory-confirmed SFTS patients hospitalized during 2010–2020 in the 154th hospital, China. A 1:1 propensity score matching with age, sex, the interval from symptom onset to admission, presence of chronic viral hepatitis, diabetes and disease severity was performed between Non-IVIG group (supportive therapy) and IVIG group (IVIG plus supportive therapy). The matching variables were adjusted to compare the case fatality rates (CFRs), viral load and laboratory parameters between the two groups. Risk ratio (RR) and 95% confidence interval (CI) were reported. Findings: Totally 2219 SFTS patients were recruited. CFRs were significantly higher in 1051 patients in IVIG group than 1168 patients in Non-IVIG group (19.0% vs. 4.6%, RR = 4.30, 95% CI 3.12–5.93). The difference remained significant after matching (17.2% vs. 5.1%, RR = 4.02, 95% CI 2.71–5.97). The CFR of IVIG group was significantly higher in all age groups, two IVIG therapy delay groups and two therapy duration groups compared to that of Non-IVIG group (all P < 0.05). IVIG therapy was related to higher viral loads and reduced counts of lymphocytes, T cells, CD4+ T cells and natural killer cells in the blood (all P < 0.05). Interpretation: No obvious efficacy of IVIG in saving life or improving outcome of SFTS was observed. Caution is needed for clinical physicians to continue prescribing IVIG for SFTS patients. Funding: Natural Science Foundation of China. |
| first_indexed | 2024-03-11T22:48:24Z |
| format | Article |
| id | doaj.art-070149d59fcd411c89d4987b9f98e05c |
| institution | Directory Open Access Journal |
| issn | 2352-3964 |
| language | English |
| last_indexed | 2024-03-11T22:48:24Z |
| publishDate | 2023-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EBioMedicine |
| spelling | doaj.art-070149d59fcd411c89d4987b9f98e05c2023-09-22T04:39:01ZengElsevierEBioMedicine2352-39642023-10-0196104807Clinical efficacy of immunoglobulin on the treatment of severe fever with thrombocytopenia syndrome: a retrospective cohort studyResearch in contextShan-Shan Zhang0Juan Du1Ning Cui2Xin Yang3Lan Zhang4Wan-Xue Zhang5Ming Yue6Yong-Xiang Wu7Tong Yang8Xiao-Ai Zhang9Zhen-Dong Yang10Hong-Di Lv11Qing-Bin Lu12Wei Liu13Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, China; Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing, ChinaCenter for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing, ChinaThe 154th Hospital, Xinyang, ChinaState Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, ChinaThe 154th Hospital, Xinyang, ChinaCenter for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing, ChinaDepartment of Infectious Diseases, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, ChinaState Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, ChinaState Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, ChinaState Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, ChinaThe 154th Hospital, Xinyang, ChinaThe 154th Hospital, Xinyang, ChinaDepartment of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, China; Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China; Corresponding author. Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, 38th Xueyuan Road, Haidian District, Beijing 100191, China.State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China; School of Public Health, Anhui Medical University, Hefei, China; Corresponding author. State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 20 Dong-Da Street, Fengtai District, Beijing 100071, China.Summary: Background: Optimal treatment strategy for severe fever with thrombocytopenia syndrome (SFTS) remained unknown. We aimed to evaluate the efficacy of intravenous immunoglobulin (IVIG) on SFTS. Methods: A retrospective cohort study was conducted based on medical records of the laboratory-confirmed SFTS patients hospitalized during 2010–2020 in the 154th hospital, China. A 1:1 propensity score matching with age, sex, the interval from symptom onset to admission, presence of chronic viral hepatitis, diabetes and disease severity was performed between Non-IVIG group (supportive therapy) and IVIG group (IVIG plus supportive therapy). The matching variables were adjusted to compare the case fatality rates (CFRs), viral load and laboratory parameters between the two groups. Risk ratio (RR) and 95% confidence interval (CI) were reported. Findings: Totally 2219 SFTS patients were recruited. CFRs were significantly higher in 1051 patients in IVIG group than 1168 patients in Non-IVIG group (19.0% vs. 4.6%, RR = 4.30, 95% CI 3.12–5.93). The difference remained significant after matching (17.2% vs. 5.1%, RR = 4.02, 95% CI 2.71–5.97). The CFR of IVIG group was significantly higher in all age groups, two IVIG therapy delay groups and two therapy duration groups compared to that of Non-IVIG group (all P < 0.05). IVIG therapy was related to higher viral loads and reduced counts of lymphocytes, T cells, CD4+ T cells and natural killer cells in the blood (all P < 0.05). Interpretation: No obvious efficacy of IVIG in saving life or improving outcome of SFTS was observed. Caution is needed for clinical physicians to continue prescribing IVIG for SFTS patients. Funding: Natural Science Foundation of China.http://www.sciencedirect.com/science/article/pii/S2352396423003730Severe fever with thrombocytopenia syndromeIntravenous immunoglobulinEfficacy evaluationRetrospective study |
| spellingShingle | Shan-Shan Zhang Juan Du Ning Cui Xin Yang Lan Zhang Wan-Xue Zhang Ming Yue Yong-Xiang Wu Tong Yang Xiao-Ai Zhang Zhen-Dong Yang Hong-Di Lv Qing-Bin Lu Wei Liu Clinical efficacy of immunoglobulin on the treatment of severe fever with thrombocytopenia syndrome: a retrospective cohort studyResearch in context EBioMedicine Severe fever with thrombocytopenia syndrome Intravenous immunoglobulin Efficacy evaluation Retrospective study |
| title | Clinical efficacy of immunoglobulin on the treatment of severe fever with thrombocytopenia syndrome: a retrospective cohort studyResearch in context |
| title_full | Clinical efficacy of immunoglobulin on the treatment of severe fever with thrombocytopenia syndrome: a retrospective cohort studyResearch in context |
| title_fullStr | Clinical efficacy of immunoglobulin on the treatment of severe fever with thrombocytopenia syndrome: a retrospective cohort studyResearch in context |
| title_full_unstemmed | Clinical efficacy of immunoglobulin on the treatment of severe fever with thrombocytopenia syndrome: a retrospective cohort studyResearch in context |
| title_short | Clinical efficacy of immunoglobulin on the treatment of severe fever with thrombocytopenia syndrome: a retrospective cohort studyResearch in context |
| title_sort | clinical efficacy of immunoglobulin on the treatment of severe fever with thrombocytopenia syndrome a retrospective cohort studyresearch in context |
| topic | Severe fever with thrombocytopenia syndrome Intravenous immunoglobulin Efficacy evaluation Retrospective study |
| url | http://www.sciencedirect.com/science/article/pii/S2352396423003730 |
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