Levels of peripheral blood routine, biochemical and coagulation parameters in patients with hemorrhagic fever with renal syndrome and their relationship with prognosis: an observational cohort study
Abstract Background Hantaan virus (HTNV), Seoul virus (SEOV) and Puumala virus (PUUV) are major serotypes of the Hantavirus, which can cause hemorrhagic fever with renal syndrome (HFRS). The pathophysiology of HFRS in humans is complex and the determinants associated with mortality, especially the c...
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-023-08777-w |
| _version_ | 1827382446999470080 |
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| author | Wen-jing Chen Hong Du Hai-feng Hu Jian-qi Lian Hong Jiang Jing Li Yan-ping Chen Ying Zhang Ping-zhong Wang |
| author_facet | Wen-jing Chen Hong Du Hai-feng Hu Jian-qi Lian Hong Jiang Jing Li Yan-ping Chen Ying Zhang Ping-zhong Wang |
| author_sort | Wen-jing Chen |
| collection | DOAJ |
| description | Abstract Background Hantaan virus (HTNV), Seoul virus (SEOV) and Puumala virus (PUUV) are major serotypes of the Hantavirus, which can cause hemorrhagic fever with renal syndrome (HFRS). The pathophysiology of HFRS in humans is complex and the determinants associated with mortality, especially the coagulation and fibrinolysis disorders, are still not been fully elucidated. Severe patients usually manifest multiple complications except for acute kidney injury (AKI). The aim of this study was to observe the levels of peripheral blood routine, biochemical and coagulation parameters during the early stage, so as to find independent risk factors closely related to the prognosis, which may provide theoretical basis for targeted treatment and evaluation. Methods A total of 395 HFRS patients from December 2015 to December 2018 were retrospectively enrolled. According to prognosis, they were divided into a survival group (n = 368) and a death group (n = 27). The peripheral blood routine, biochemical and coagulation parameters were compared between the two groups on admission. The relationship between the parameters mentioned above and prognosis was analyzed, and the dynamic changes of the coagulation and fibrinolysis parameters during the first week after admission were further observed. Results In addition to AKI, liver injury was also common among the enrolled patients. Patients in the death group manifested higher levels of white blood cell counts (WBC) on admission. 27.30% (107/392) of the patients enrolled presented with disseminated intravascular coagulation (DIC) on admission and DIC is more common in the death group; The death patients manifested longer prothrombin time (PT) and activated partial thromboplastin time (APTT), higher D-dimer and fibrinogen degradation product (FDP), and lower levels of platelets (PLT) and fibrinogen (Fib) compared with those of the survival patients. The proportion of D-dimer and FDP abnormalities are higher than PT, APTT and Fib. Prolonged PT, low level of Fib and elevated total bilirubin (TBIL) on admission were considered as independent risk factors for prognosis (death). Conclusions Detection of PT, Fib and TBIL on admission is necessary, which might be benefit to early predicting prognosis. It is also important to pay attention to the dynamic coagulation disorders and hyperfibrinolysis during the early stage in the severe HFRS patients. |
| first_indexed | 2024-03-08T14:19:45Z |
| format | Article |
| id | doaj.art-ff66eae9592a4c7aa08c78eaed831f0c |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-03-08T14:19:45Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-ff66eae9592a4c7aa08c78eaed831f0c2024-01-14T12:13:17ZengBMCBMC Infectious Diseases1471-23342024-01-0124111310.1186/s12879-023-08777-wLevels of peripheral blood routine, biochemical and coagulation parameters in patients with hemorrhagic fever with renal syndrome and their relationship with prognosis: an observational cohort studyWen-jing Chen0Hong Du1Hai-feng Hu2Jian-qi Lian3Hong Jiang4Jing Li5Yan-ping Chen6Ying Zhang7Ping-zhong Wang8Center for Infectious Diseases, the Second Affiliated Hospital of Air Force Medical UniversityCenter for Infectious Diseases, the Second Affiliated Hospital of Air Force Medical UniversityCenter for Infectious Diseases, the Second Affiliated Hospital of Air Force Medical UniversityCenter for Infectious Diseases, the Second Affiliated Hospital of Air Force Medical UniversityCenter for Infectious Diseases, the Second Affiliated Hospital of Air Force Medical UniversityCenter for Infectious Diseases, the Second Affiliated Hospital of Air Force Medical UniversityDepartment of Infectious Diseases, the Second Affiliated People’s Hospital of Yan ‘an UniversityCenter for Infectious Diseases, the Second Affiliated Hospital of Air Force Medical UniversityCenter for Infectious Diseases, the Second Affiliated Hospital of Air Force Medical UniversityAbstract Background Hantaan virus (HTNV), Seoul virus (SEOV) and Puumala virus (PUUV) are major serotypes of the Hantavirus, which can cause hemorrhagic fever with renal syndrome (HFRS). The pathophysiology of HFRS in humans is complex and the determinants associated with mortality, especially the coagulation and fibrinolysis disorders, are still not been fully elucidated. Severe patients usually manifest multiple complications except for acute kidney injury (AKI). The aim of this study was to observe the levels of peripheral blood routine, biochemical and coagulation parameters during the early stage, so as to find independent risk factors closely related to the prognosis, which may provide theoretical basis for targeted treatment and evaluation. Methods A total of 395 HFRS patients from December 2015 to December 2018 were retrospectively enrolled. According to prognosis, they were divided into a survival group (n = 368) and a death group (n = 27). The peripheral blood routine, biochemical and coagulation parameters were compared between the two groups on admission. The relationship between the parameters mentioned above and prognosis was analyzed, and the dynamic changes of the coagulation and fibrinolysis parameters during the first week after admission were further observed. Results In addition to AKI, liver injury was also common among the enrolled patients. Patients in the death group manifested higher levels of white blood cell counts (WBC) on admission. 27.30% (107/392) of the patients enrolled presented with disseminated intravascular coagulation (DIC) on admission and DIC is more common in the death group; The death patients manifested longer prothrombin time (PT) and activated partial thromboplastin time (APTT), higher D-dimer and fibrinogen degradation product (FDP), and lower levels of platelets (PLT) and fibrinogen (Fib) compared with those of the survival patients. The proportion of D-dimer and FDP abnormalities are higher than PT, APTT and Fib. Prolonged PT, low level of Fib and elevated total bilirubin (TBIL) on admission were considered as independent risk factors for prognosis (death). Conclusions Detection of PT, Fib and TBIL on admission is necessary, which might be benefit to early predicting prognosis. It is also important to pay attention to the dynamic coagulation disorders and hyperfibrinolysis during the early stage in the severe HFRS patients.https://doi.org/10.1186/s12879-023-08777-wHemorrhagic fever with renal syndromeCoagulation parametersHyperfibrinolysisRisk factorsPrognosis |
| spellingShingle | Wen-jing Chen Hong Du Hai-feng Hu Jian-qi Lian Hong Jiang Jing Li Yan-ping Chen Ying Zhang Ping-zhong Wang Levels of peripheral blood routine, biochemical and coagulation parameters in patients with hemorrhagic fever with renal syndrome and their relationship with prognosis: an observational cohort study BMC Infectious Diseases Hemorrhagic fever with renal syndrome Coagulation parameters Hyperfibrinolysis Risk factors Prognosis |
| title | Levels of peripheral blood routine, biochemical and coagulation parameters in patients with hemorrhagic fever with renal syndrome and their relationship with prognosis: an observational cohort study |
| title_full | Levels of peripheral blood routine, biochemical and coagulation parameters in patients with hemorrhagic fever with renal syndrome and their relationship with prognosis: an observational cohort study |
| title_fullStr | Levels of peripheral blood routine, biochemical and coagulation parameters in patients with hemorrhagic fever with renal syndrome and their relationship with prognosis: an observational cohort study |
| title_full_unstemmed | Levels of peripheral blood routine, biochemical and coagulation parameters in patients with hemorrhagic fever with renal syndrome and their relationship with prognosis: an observational cohort study |
| title_short | Levels of peripheral blood routine, biochemical and coagulation parameters in patients with hemorrhagic fever with renal syndrome and their relationship with prognosis: an observational cohort study |
| title_sort | levels of peripheral blood routine biochemical and coagulation parameters in patients with hemorrhagic fever with renal syndrome and their relationship with prognosis an observational cohort study |
| topic | Hemorrhagic fever with renal syndrome Coagulation parameters Hyperfibrinolysis Risk factors Prognosis |
| url | https://doi.org/10.1186/s12879-023-08777-w |
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