New Insight for the Prognosis of CCHF: Clinical, Laboratory and Sonography Findings

Page: [1125 - 1130] Pages: 6

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Abstract

Background: Crimean Congo Hemorrhagic Fever (CCHF) is an acute and fatal disease with various clinical and paraclinical characteristics.

Introduction: In this article, we report data on confirmed CCHF cases from Iran and describe the association between studying factors and outcomes of the disease.

Methods: In the study design, we evaluated demographic characteristics, clinical, laboratory and sonographic findings of 160 CCHF confirmed cases during 2003 and 2012 in Zabol (A city in Sistan and Baluchestan province of Iran). The association between these factors and the fatal outcome were evaluated by regression analysis.

Results: The disease had a fatal outcome in 7 (4.4%) patients. Females had more severe symptoms and higher odds for death (odds ratio11.57, p=0.005). Leukocytosis (p<0.001), PT (p<0.001) and PTT (p=0.008) elongation, AST (p=0.010) and ALT (p>0.001) elevation were significantly associated with fatal outcome. CNS related symptoms (odds ratio 5.9, p=0.027) in clinical examination and ascites (odds ratio 38.4, p=0.012) and liquid in the pelvic cavity (odds ratio 24.2, p=0.004) were also identified as risk factors of death in this study.

Conclusion: Our data suggest that in addition to clinical and laboratory findings practitioners consider sonography for CCHF prognosis.

Keywords: Crimean–Congo hemorrhagic fever, viral, fatal disease, clinical, laboratory, sonography.

Graphical Abstract

[2]
Chinikar S, Ghiasi SM, Moradi M, et al. Geographical distribution and surveillance of Crimean-Congo hemorrhagic fever in Iran. Vector Borne Zoonotic Dis 2010; 10(7): 705-8.
[http://dx.doi.org/10.1089/vbz.2009.0247] [PMID: 20854025]
[3]
Chinikar S, Goya MM, Shirzadi MR, et al. Surveillance and laboratory detection system of Crimean-Congo haemorrhagic fever in Iran. Transbound Emerg Dis 2008; 55(5-6): 200-4.
[http://dx.doi.org/10.1111/j.1865-1682.2008.01028.x] [PMID: 18666963]
[4]
Çevik MA, Erbay A, Bodur H, et al. Clinical and laboratory features of Crimean-Congo hemorrhagic fever: Predictors of fatality. Int J Infect Dis 2008; 12(4): 374-9.
[http://dx.doi.org/10.1016/j.ijid.2007.09.010] [PMID: 18063402]
[5]
Tufan ZK, Yigit H, Kacar M, et al. Sonographic findings in patients with Crimean-Congo hemorrhagic fever. J Ultrasound Med 2014; 33(11): 1999-2003.
[http://dx.doi.org/10.7863/ultra.33.11.1999] [PMID: 25336488]
[6]
Ziraman I, Celikbas A, Ergonul O, et al. Crimean-Congo hemorrhagic fever: aid of abdominal ultrasonography in prediction of severity. Vector Borne Zoonotic Dis 2014; 14(11): 817-20.
[http://dx.doi.org/10.1089/vbz.2014.1662] [PMID: 25409273]
[7]
Burki TK. Ticks and Turkey. Lancet 2012; 380(9857): 1897-8.
[http://dx.doi.org/10.1016/S0140-6736(12)62097-2] [PMID: 23210134]
[8]
Chinikar S, Ghiasi SM, Hewson R, Moradi M, Haeri A. Crimean-Congo hemorrhagic fever in Iran and neighboring countries. J Clin Virol 2010; 47(2): 110-4.
[http://dx.doi.org/10.1016/j.jcv.2009.10.014] [PMID: 20006541]
[9]
Ergönül O, Celikbaş A, Dokuzoğuz B, Eren S, Baykam N, Esener H. Characteristics of patients with Crimean-Congo hemorrhagic fever in a recent outbreak in Turkey and impact of oral ribavirin therapy. Clin Infect Dis 2004; 39(2): 284-7.
[http://dx.doi.org/10.1086/422000] [PMID: 15307042]
[10]
Mardani M, Jahromi MK, Naieni KH, Zeinali M. The efficacy of oral ribavirin in the treatment of crimean-congo hemorrhagic fever in Iran. Clin Infect Dis 2003; 36(12): 1613-8.
[http://dx.doi.org/10.1086/375058] [PMID: 12802764]
[11]
Owaysee H, Eini P, Eizadi M, Oghli N, Saravani S. Assessment of patients with Crimean-Congo hemorrhagic fever admitted in Amir-Almomenin Hospital of Zabol from 2003 to 2005. J Mil Med 2008; 9(4): 303-8.
[12]
Owaysee Osquee H, Eini P, Oghli N. Presentation of a pregnant woman with Crimean-Congo hemorrhagic fever. Sci J Hamdan Univ Med Sci 1986; 14(4): 64-7.
[13]
Owaysee Osquee H, Pourjafar H, Taghizadeh S, Haghdoost M, Ansari F. Laboratory features of 160 CCHF confirmed cases in Zabol of Iran: A 10-year study. J Infect 2017; 74(4): 418-20.
[http://dx.doi.org/10.1016/j.jinf.2016.12.003] [PMID: 27998751]
[14]
Hasanoglu I, Guner R, Carhan A, et al. Crucial parameter of the outcome in Crimean Congo hemorrhagic fever: Viral load. J Clin Virol 2016; 75: 42-6.
[http://dx.doi.org/10.1016/j.jcv.2015.12.006] [PMID: 26780111]
[15]
Ozturk B, Tutuncu E, Kuscu F, Gurbuz Y, Sencan I, Tuzun H. Evaluation of factors predictive of the prognosis in Crimean-Congo hemorrhagic fever: New suggestions. Int J Infect Dis 2012; 16(2): e89-93.
[http://dx.doi.org/10.1016/j.ijid.2011.06.005] [PMID: 22154082]
[16]
Ergönül O. Crimean-Congo haemorrhagic fever. Lancet Infect Dis 2006; 6(4): 203-14.
[http://dx.doi.org/10.1016/S1473-3099(06)70435-2] [PMID: 16554245]
[17]
Swanepoel R, Gill DE, Shepherd AJ, Leman PA, Mynhardt JH, Harvey S. The clinical pathology of Crimean-Congo hemorrhagic fever. Rev Infect Dis 1989; 11(Suppl. 4): S794-800.
[http://dx.doi.org/10.1093/clinids/11.Supplement_4.S794] [PMID: 2749111]