The Clinical Presentation of Puumala Hantavirus Induced Hemorrhagic Fever with Renal Syndrome Is Related to Plasma Glucose Concentration
Puumala hantavirus (PUUV) causes a hemorrhagic fever with renal syndrome characterized by thrombocytopenia, increased capillary leakage, and acute kidney injury (AKI). As glucosuria at hospital admission predicts the severity of PUUV infection, we explored how plasma glucose concentration associates...
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| Format: | Article |
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MDPI AG
2021-06-01
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| Series: | Viruses |
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| Online Access: | https://www.mdpi.com/1999-4915/13/6/1177 |
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| author | Johanna Tietäväinen Satu Mäkelä Heini Huhtala Ilkka H. Pörsti Tomas Strandin Antti Vaheri Jukka Mustonen |
| author_facet | Johanna Tietäväinen Satu Mäkelä Heini Huhtala Ilkka H. Pörsti Tomas Strandin Antti Vaheri Jukka Mustonen |
| author_sort | Johanna Tietäväinen |
| collection | DOAJ |
| description | Puumala hantavirus (PUUV) causes a hemorrhagic fever with renal syndrome characterized by thrombocytopenia, increased capillary leakage, and acute kidney injury (AKI). As glucosuria at hospital admission predicts the severity of PUUV infection, we explored how plasma glucose concentration associates with disease severity. Plasma glucose values were measured during hospital care in 185 patients with PUUV infection. They were divided into two groups according to maximum plasma glucose concentration: P-Gluc < 7.8 mmol/L (<i>n</i> = 134) and P-Gluc ≥ 7.8 mmol/L (<i>n</i> = 51). The determinants of disease severity were analyzed across groups. Patients with P-Gluc ≥7.8 mmol/L had higher hematocrit (0.46 vs. 0.43; <i>p</i> < 0.001) and lower plasma albumin concentration (24 vs. 29 g/L; <i>p</i> < 0.001) than patients with P-Gluc < 7.8 mmol/L. They presented with higher prevalence of pulmonary infiltrations and pleural effusion in chest radiograph, higher prevalence of shock and greater weight change during hospitalization. Patients with P-Gluc ≥ 7.8 mmol/L were characterized by lower platelet count (50 vs. 66 × 10<sup>9</sup>/L; <i>p</i> = 0.001), more severe AKI (plasma creatinine 272 vs. 151 µmol/L; <i>p</i> = 0.001), and longer hospital treatment (8 vs. 6 days; <i>p</i> < 0.001) than patients with P-Gluc < 7.8 mmol/L. Plasma glucose level is associated with the severity of capillary leakage, thrombocytopenia, inflammation, and AKI in patients with acute PUUV infection. |
| first_indexed | 2024-03-10T10:14:31Z |
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| id | doaj.art-37f82c67e3484d1a84b8d0545921375a |
| institution | Directory Open Access Journal |
| issn | 1999-4915 |
| language | English |
| last_indexed | 2024-03-10T10:14:31Z |
| publishDate | 2021-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Viruses |
| spelling | doaj.art-37f82c67e3484d1a84b8d0545921375a2023-11-22T00:54:20ZengMDPI AGViruses1999-49152021-06-01136117710.3390/v13061177The Clinical Presentation of Puumala Hantavirus Induced Hemorrhagic Fever with Renal Syndrome Is Related to Plasma Glucose ConcentrationJohanna Tietäväinen0Satu Mäkelä1Heini Huhtala2Ilkka H. Pörsti3Tomas Strandin4Antti Vaheri5Jukka Mustonen6Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, FinlandFaculty of Medicine and Health Technology, Tampere University, 33520 Tampere, FinlandFaculty of Social Sciences, Tampere University, 33520 Tampere, FinlandFaculty of Medicine and Health Technology, Tampere University, 33520 Tampere, FinlandDepartment of Virology, Medicum, University of Helsinki, 00290 Helsinki, FinlandDepartment of Virology, Medicum, University of Helsinki, 00290 Helsinki, FinlandFaculty of Medicine and Health Technology, Tampere University, 33520 Tampere, FinlandPuumala hantavirus (PUUV) causes a hemorrhagic fever with renal syndrome characterized by thrombocytopenia, increased capillary leakage, and acute kidney injury (AKI). As glucosuria at hospital admission predicts the severity of PUUV infection, we explored how plasma glucose concentration associates with disease severity. Plasma glucose values were measured during hospital care in 185 patients with PUUV infection. They were divided into two groups according to maximum plasma glucose concentration: P-Gluc < 7.8 mmol/L (<i>n</i> = 134) and P-Gluc ≥ 7.8 mmol/L (<i>n</i> = 51). The determinants of disease severity were analyzed across groups. Patients with P-Gluc ≥7.8 mmol/L had higher hematocrit (0.46 vs. 0.43; <i>p</i> < 0.001) and lower plasma albumin concentration (24 vs. 29 g/L; <i>p</i> < 0.001) than patients with P-Gluc < 7.8 mmol/L. They presented with higher prevalence of pulmonary infiltrations and pleural effusion in chest radiograph, higher prevalence of shock and greater weight change during hospitalization. Patients with P-Gluc ≥ 7.8 mmol/L were characterized by lower platelet count (50 vs. 66 × 10<sup>9</sup>/L; <i>p</i> = 0.001), more severe AKI (plasma creatinine 272 vs. 151 µmol/L; <i>p</i> = 0.001), and longer hospital treatment (8 vs. 6 days; <i>p</i> < 0.001) than patients with P-Gluc < 7.8 mmol/L. Plasma glucose level is associated with the severity of capillary leakage, thrombocytopenia, inflammation, and AKI in patients with acute PUUV infection.https://www.mdpi.com/1999-4915/13/6/1177puumala hantavirushyperglycemiacapillary leakagethrombocytopeniaAKIendothelial damage |
| spellingShingle | Johanna Tietäväinen Satu Mäkelä Heini Huhtala Ilkka H. Pörsti Tomas Strandin Antti Vaheri Jukka Mustonen The Clinical Presentation of Puumala Hantavirus Induced Hemorrhagic Fever with Renal Syndrome Is Related to Plasma Glucose Concentration Viruses puumala hantavirus hyperglycemia capillary leakage thrombocytopenia AKI endothelial damage |
| title | The Clinical Presentation of Puumala Hantavirus Induced Hemorrhagic Fever with Renal Syndrome Is Related to Plasma Glucose Concentration |
| title_full | The Clinical Presentation of Puumala Hantavirus Induced Hemorrhagic Fever with Renal Syndrome Is Related to Plasma Glucose Concentration |
| title_fullStr | The Clinical Presentation of Puumala Hantavirus Induced Hemorrhagic Fever with Renal Syndrome Is Related to Plasma Glucose Concentration |
| title_full_unstemmed | The Clinical Presentation of Puumala Hantavirus Induced Hemorrhagic Fever with Renal Syndrome Is Related to Plasma Glucose Concentration |
| title_short | The Clinical Presentation of Puumala Hantavirus Induced Hemorrhagic Fever with Renal Syndrome Is Related to Plasma Glucose Concentration |
| title_sort | clinical presentation of puumala hantavirus induced hemorrhagic fever with renal syndrome is related to plasma glucose concentration |
| topic | puumala hantavirus hyperglycemia capillary leakage thrombocytopenia AKI endothelial damage |
| url | https://www.mdpi.com/1999-4915/13/6/1177 |
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