Difference in hematocrit and plasma albumin levels as an early biomarker of severity and prognosis in patients with severe fever and thrombocytopenia syndrome

IF 6.8 3区医学 Q1 VIROLOGY

Journal of Medical Virology Pub Date : 2024-10-01 DOI:10.1002/jmv.29941

Yao Hao, Jing Sun, Xiaoyi Wang, Qiongle Wu, Wenjie Wang, Aiping Zhang, B. S. Huifen Kuai, Jianghua Yang

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引用次数: 0

Abstract

Severe fever with thrombocytopenia syndrome (SFTS) is a widespread infectious disease with high mortality. Hence, identifying valuable biomarkers for detecting the early changes in SFTS is crucial. In this study, we investigated the relationship between the difference in hematocrit (HCT) and serum albumin (ALB) levels (HCT-ALB) and the prognosis of patients with SFTS virus infection. After excluding the patients who did not meet the SFTS diagnostic criteria, those with SFTS from the First Affiliated Hospital of Wannan Medical College were divided into a fatal and Nonfatal group based on their disease prognosis. A dynamic analysis of the daily laboratory data was conducted for 14 days following SFTS onset. A receiver operating characteristic (ROC) curve was used to evaluate the predictive value of HCT-ALB. Another sample of patients with SFTS admitted to the First Affiliated Hospital of Nanjing Medical University was utilized to verify the study conclusions. A total of 158 patients with SFTS were included. Among them, 126 patients were categorized in the Nonfatal group and 32 in the fatal group, leading to a mortality rate of 20.25% (32/158). Univariate analysis of the laboratory test findings and ROC curve analysis showed that alanine aminotransferase (ALT), aspartate aminotransferase (AST), HCT-ALB, and lactate dehydrogenase (LDH) had a relatively better ability to discriminate the disease condition of the patients with SFTS. Moreover, HCT-ALB served as a predictor of SFTS prognosis. Additionally, an area under the ROC curve (AUC) of 0.777 and a critical HCT-ALB value of 4.75 on day 7 were associated with a sensitivity of 83.3% and a specificity of 73.9%. On day 8 (AUC = 0.882), the critical value of HCT-ALB was 9.25, while the sensitivity was 100% and specificity was 76.5%. Further verification based on the data of 91 patients with SFTS admitted to the First Affiliated Hospital of Nanjing Medical University demonstrated a mortality rate of 51% (24/47) among those with HCT-ALB values >4.75 on day 7 of the disease course, highlighting the potential of the HCT-ALB value of >4.75 for predicting SFTS prognosis. High HCT-ALB values are closely related to the mortality of patients with SFTS. HCT-ALB is a sensitive and independent predictor of early disease in patients with SFTS.

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血细胞比容和血浆白蛋白水平的差异是严重发热和血小板减少综合征患者病情严重程度和预后的早期生物标志物。

严重发热伴血小板减少综合征（SFTS）是一种死亡率很高的广泛传染病。因此，确定有价值的生物标志物以检测 SFTS 的早期变化至关重要。在这项研究中，我们探讨了血细胞比容（HCT）和血清白蛋白（ALB）水平的差异（HCT-ALB）与 SFTS 病毒感染患者预后之间的关系。在排除不符合SFTS诊断标准的患者后，根据预后将皖南医学院第一附属医院的SFTS患者分为致死组和非致死组。对 SFTS 发病后 14 天内的每日实验室数据进行动态分析。采用接收者操作特征曲线（ROC）评估 HCT-ALB 的预测价值。南京医科大学第一附属医院收治的另一批SFTS患者样本也用于验证研究结论。研究共纳入158例SFTS患者。其中，126例患者被归入非死亡组，32例被归入死亡组，死亡率为20.25%（32/158）。化验结果的单变量分析和 ROC 曲线分析显示，丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、HCT-ALB 和乳酸脱氢酶（LDH）对 SFTS 患者病情的鉴别能力相对较强。此外，HCT-ALB还是SFTS预后的预测因子。此外，第7天的ROC曲线下面积（AUC）为0.777，HCT-ALB临界值为4.75，其敏感性为83.3%，特异性为73.9%。第 8 天（AUC = 0.882），HCT-ALB 临界值为 9.25，敏感性为 100%，特异性为 76.5%。根据南京医科大学第一附属医院收治的91名SFTS患者的数据进一步验证，病程第7天HCT-ALB值>4.75的患者死亡率为51%（24/47），这突出表明HCT-ALB值>4.75在预测SFTS预后方面的潜力。高HCT-ALB值与SFTS患者的死亡率密切相关。HCT-ALB是预测SFTS患者早期疾病的一个敏感而独立的指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Medical Virology 医学-病毒学

CiteScore

23.20

自引率

2.40%

发文量

777

审稿时长

1 months

期刊介绍： The Journal of Medical Virology focuses on publishing original scientific papers on both basic and applied research related to viruses that affect humans. The journal publishes reports covering a wide range of topics, including the characterization, diagnosis, epidemiology, immunology, and pathogenesis of human virus infections. It also includes studies on virus morphology, genetics, replication, and interactions with host cells. The intended readership of the journal includes virologists, microbiologists, immunologists, infectious disease specialists, diagnostic laboratory technologists, epidemiologists, hematologists, and cell biologists. The Journal of Medical Virology is indexed and abstracted in various databases, including Abstracts in Anthropology (Sage), CABI, AgBiotech News & Information, National Agricultural Library, Biological Abstracts, Embase, Global Health, Web of Science, Veterinary Bulletin, and others.