Effects of corticosteroid treatment in patients with severe fever with thrombocytopenia syndrome: A single-center retrospective cohort study

Objectives: To evaluate the effect and safety of corticosteroid (CS) treatment in patients with severe fever with thrombocytopenia syndrome (SFTS). Methods: Patients with and without CS were retrospectively compared by Cox regression and 1:1 propensity score matching analysis to evaluate the effects...

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Main Authors: Leiqun Xiong, Ling Xu, Xiaoying Lv, Xin Zheng
Format: Article
Language:English
Published: Elsevier 2022-09-01
Series:International Journal of Infectious Diseases
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1201971222003964
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author Leiqun Xiong
Ling Xu
Xiaoying Lv
Xin Zheng
author_facet Leiqun Xiong
Ling Xu
Xiaoying Lv
Xin Zheng
author_sort Leiqun Xiong
collection DOAJ
description Objectives: To evaluate the effect and safety of corticosteroid (CS) treatment in patients with severe fever with thrombocytopenia syndrome (SFTS). Methods: Patients with and without CS were retrospectively compared by Cox regression and 1:1 propensity score matching analysis to evaluate the effects of CS on mortality and secondary infections in patients with SFTS. Results: A total of 467 patients with SFTS were enrolled in the cohort study, there were 52 fatal cases and 415 nonfatal cases, the overall fatality rate was 11.1%. The mortality was observed in 36/144 (25%) and 16/323 (5%) patients in the CS-treated and non-CS-treated groups, respectively (P < 0.001). Multi variate Cox regression analysis showed that the difference was not statistically significant for CS treatment in fatality (P > 0.05, aHR 0.767, 95% CI 0.360-1.634). Difference in survival time between the CS-treated and non-CS-treated groups after propensity score matching had no statistical significance (Log-rank test P = 0.390), whereas there was a significant difference in secondary infections between the CS-treated and non-CS-treated groups (P = 0.007). Conclusion: Although the CS treatment had no impact on fatality in patients with SFTS, it increased the risk of secondary infections. Administration of CS in patients with SFTS should be carefully considered and evaluated the balance between therapeutic efficacy and adverse effects.
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spelling doaj.art-80cf075fe2b44b048c8fa376b82c9b452022-12-22T04:23:54ZengElsevierInternational Journal of Infectious Diseases1201-97122022-09-0112210261033Effects of corticosteroid treatment in patients with severe fever with thrombocytopenia syndrome: A single-center retrospective cohort studyLeiqun Xiong0Ling Xu1Xiaoying Lv2Xin Zheng3Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China; Joint International Laboratory of Infection and Immunity, Huazhong University of Science and Technology, Wuhan 43000, China; Department of Transfusion, Zhongshan Hospital (Xiamen), Fudan University, Xiamen Clinical Research Center for Cancer Therapy, Xiamen, 361015, ChinaDepartment of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China; Joint International Laboratory of Infection and Immunity, Huazhong University of Science and Technology, Wuhan 43000, ChinaDepartment of Transfusion, Zhongshan Hospital (Xiamen), Fudan University, Xiamen Clinical Research Center for Cancer Therapy, Xiamen, 361015, ChinaDepartment of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China; Joint International Laboratory of Infection and Immunity, Huazhong University of Science and Technology, Wuhan 43000, China; Corresponding author.Objectives: To evaluate the effect and safety of corticosteroid (CS) treatment in patients with severe fever with thrombocytopenia syndrome (SFTS). Methods: Patients with and without CS were retrospectively compared by Cox regression and 1:1 propensity score matching analysis to evaluate the effects of CS on mortality and secondary infections in patients with SFTS. Results: A total of 467 patients with SFTS were enrolled in the cohort study, there were 52 fatal cases and 415 nonfatal cases, the overall fatality rate was 11.1%. The mortality was observed in 36/144 (25%) and 16/323 (5%) patients in the CS-treated and non-CS-treated groups, respectively (P < 0.001). Multi variate Cox regression analysis showed that the difference was not statistically significant for CS treatment in fatality (P > 0.05, aHR 0.767, 95% CI 0.360-1.634). Difference in survival time between the CS-treated and non-CS-treated groups after propensity score matching had no statistical significance (Log-rank test P = 0.390), whereas there was a significant difference in secondary infections between the CS-treated and non-CS-treated groups (P = 0.007). Conclusion: Although the CS treatment had no impact on fatality in patients with SFTS, it increased the risk of secondary infections. Administration of CS in patients with SFTS should be carefully considered and evaluated the balance between therapeutic efficacy and adverse effects.http://www.sciencedirect.com/science/article/pii/S1201971222003964Severe fever with thrombocytopenia syndromeCorticosteroidTreatmentFatalitySecondary infections
spellingShingle Leiqun Xiong
Ling Xu
Xiaoying Lv
Xin Zheng
Effects of corticosteroid treatment in patients with severe fever with thrombocytopenia syndrome: A single-center retrospective cohort study
International Journal of Infectious Diseases
Severe fever with thrombocytopenia syndrome
Corticosteroid
Treatment
Fatality
Secondary infections
title Effects of corticosteroid treatment in patients with severe fever with thrombocytopenia syndrome: A single-center retrospective cohort study
title_full Effects of corticosteroid treatment in patients with severe fever with thrombocytopenia syndrome: A single-center retrospective cohort study
title_fullStr Effects of corticosteroid treatment in patients with severe fever with thrombocytopenia syndrome: A single-center retrospective cohort study
title_full_unstemmed Effects of corticosteroid treatment in patients with severe fever with thrombocytopenia syndrome: A single-center retrospective cohort study
title_short Effects of corticosteroid treatment in patients with severe fever with thrombocytopenia syndrome: A single-center retrospective cohort study
title_sort effects of corticosteroid treatment in patients with severe fever with thrombocytopenia syndrome a single center retrospective cohort study
topic Severe fever with thrombocytopenia syndrome
Corticosteroid
Treatment
Fatality
Secondary infections
url http://www.sciencedirect.com/science/article/pii/S1201971222003964
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