Prediction of Mortality by Clinical Laboratory Parameters in Severe Fever with Thrombocytopenia Syndrome: A Meta-Analysis.

Background: This study intended to fully assess the predictive efficiency of different clinical laboratory parameters for the mortality risk in severe fever with thrombocytopenia syndrome (SFTS).

Methods: We systematically searched the Web of Science, PubMed, Cochrane Library, and Embase up to 13 December 2024 for studies on the association of laboratory parameters with SFTS mortality. Two investigators were independently responsible for the study screening and data extraction, and they assessed the study quality using the Newcastle-Ottawa Scale (NOS). Stata17.0 was adopted for the meta-analyses.

Results: We finally included 33 observational studies involving 9502 participants (1799 deaths and 7703 survivors). The results showed that increases in the viral load (odds ratio (OR) 1.93, 95% confidence interval (CI) 1.56-2.38), neutrophil-to-lymphocyte ratio (hazard ratio (HR) 1.31, 95% CI 1.13-1.51), neutrophil percentage (HR 1.02, 95% CI 1.01-1.03), white blood cells (HR 1.06, 95% CI 1.01-1.11), activated partial thromboplastin time (OR 1.07, 95% CI 1.04-1.09), prothrombin time (OR 1.31, 95% CI 1.03-1.65), creatine kinase-myocardial band (OR 1.01, 95% CI 1.01-1.02), and procalcitonin (HR 1.27, 95% CI 1.10-1.47) greatly increased the SFTS mortality, while decreases in the lymphocyte percentage (HR 0.96, 95% CI 0.94-0.98), platelets (HR 0.98, 95% CI 0.97-0.99), and albumin (HR 0.91, 95% CI 0.86-0.96) also greatly increased the SFTS mortality; the results were all statistically significant (p < 0.05).

Conclusion: Abnormalities of laboratory parameters (e.g., viral load, blood routine, coagulation, multi-organ dysfunction, and inflammation indicators) are good predictors of SFTS mortality, which can provide valuable references in clinical practice.