Study On The Clinical Characteristics Of Severe Fever With Thrombocytopenia Syndrome

Objective To investigate regional epidemiology,clinical characteristics and prognostic factors by retrospectively assessing severe fever with thrombocytopenia syndrome(SFTS).Methods Total of 51 cases of SFTS in Tiantai County People’s Hospital were grouped based on the survivals or not.Epidemiology,clinical and laboratory findings,treatment and prognosis were systematically reviewed,and the data were statistically analyzed.Results Of 51 SFTS patients,25 were males and 26 females;average ages of 66.69±10.57 years.16 cases had history of tick biting.The first symptom was fever in all the patients,followed by muscle ache,nausea and vomiting,abdominal pain and diarrhea,lymphadenopathy or pain,hemorrhage,neuropsychiatric symptoms in 41,34,30,29,22 and 14 cases,respectively.Pulmonary infection,atrial fibrillation,heart failure,and dead were 22,10,13 and 9,respectively.Neuropsychiatric,atrial fibrillation and heart failure occurred highly in the fatal cases(χ2 values are17.137,11.942,7.301,respectively.P<0.05).PLT,ALT,AST,LDH,CK,Ca2+,ALB,APTT,TT and plasma D dimer on the date of 111 th and 14th differed from the fatal cases to the survivals(Z values arel.955,3.582,6.130,14.548,17.952,2.210,2.592,18.820,21.570,2.940,respectively.P<0.05).Univariate logistic regression,age(OR=0.871,95CI:0.887-0.963),neuropsychiatric symptoms(OR=60.0,95CI:8.783-409.862),bleeding symptoms(OR=4.5,95CI:1.133-17.878),lung infections(OR=8.7,95CI:1.958-38.652),atrial fibrillation(OR=16.8,95CI:3.244-86.994)were related to the progression to critical illness.Conclusion From 2012 to 2019,SFTS were mainly distributed in eastern mountainous villages and towns in Tiantai county,and the majority of the patients were middle-aged and elderly farmers.Occurrent neuropsychiatrics,atrial fibrillation,and heart failure could reduce the SFTS survival.The increased ALT,AST,LDH,CK,APTT,TT,plasma D dimer and the decreased PLT,ALB and Ca2+ in SFTS critical period might forebode a critical illness and worse prognosis.These findings may provide a guide for the rational treatment of SFTS and reduce its mortality.Older age,neuropsychiatric symptoms,bleeding symptoms,pulmonary infections,and atrial fibrillation may be risk factors for progression to severe forms.