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Observational Study
. 2024 Jan 11;24(1):75.
doi: 10.1186/s12879-023-08777-w.

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

Wen-Jing Chen #  1 , Hong Du #  2 , Hai-Feng Hu  1 , Jian-Qi Lian  1 , Hong Jiang  1 , Jing Li  1 , Yan-Ping Chen  3 , Ying Zhang  4 , Ping-Zhong Wang  5
Affiliations
Observational Study

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

Wen-Jing Chen et al. BMC Infect Dis. .

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.

Keywords: Coagulation parameters; Hemorrhagic fever with renal syndrome; Hyperfibrinolysis; Prognosis; Risk factors.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Box plots of peripheral blood routine, biochemical and coagulation parameters on admission in the HFRS patients
Fig. 2
Fig. 2
Predictive efficacy of PT, Fib, TBIL and their combination on admission for prognosis (death) in HFRS patients by ROC analysis
Fig. 3
Fig. 3
Dynamic changes of peripheral coagulation parameters in the HFRS patients during the first week after admission
Fig. 4
Fig. 4
Dynamic changes of the peripheral coagulation parameters in the survivors and non-survivors from day 1 to day 5 after admission
See this image and copyright information in PMC

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References

    1. Koehler FC, Cristanziano VD, Späth MR, Hoyer-Allo KR, Wanken M, Müller RU, et al. The kidney in hantavirus infection–epidemiology, virology, pathophysiology, clinical presentation, diagnosis and management. Clin Kidney J. 2022;15:1231–1252. doi: 10.1093/ckj/sfac008. - DOI - PMC - PubMed
    1. Tariq M, Kim DM. Hemorrhagic fever with renal syndrome: literature review, epidemiology, clinical picture and pathogenesis. Infect Chemother. 2022;54:1–19. doi: 10.3947/ic.2021.0148. - DOI - PMC - PubMed
    1. Koskela S, Mäkelä S, Strandin T, Vaheri A, Outinen T, Joutsi-Korhonen L, et al. Coagulopathy in Acute Puumala Hantavirus Infection. Viruses. 2021;13:1553. doi: 10.3390/v13081553. - DOI - PMC - PubMed
    1. Jiang H, Du H, Wang LM, Wang PZ, Bai XF. Hemorrhagic Fever with Renal Syndrome: Pathogenesis and Clinical Picture. Front Cell Infect Microbiol. 2016;6:1. - PMC - PubMed
    1. Hepojoki J, Vaheri A, Strandin T. The fundamental role of endothelial cells in hantavirus pathogenesis. Front Microbiol. 2014;5:727. doi: 10.3389/fmicb.2014.00727. - DOI - PMC - PubMed

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