The Evaluation of Surrogate Laboratory Parameters for Predicting the Trend of Viral Loads in Patients with Severe Fever with Thrombocytopenia Syndrome: Cross-Correlation Analysis of Time Series

김미선; Oh Hyunjoo; Heo Sang Taek; Song Sung Wook; Lee Keun Hwa; Kang Myeong Jin; Yoo Jeong Rae

doi:10.3947/ic.2022.0073

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저자정보: 김미선 (Department of Internal Medicine Jeju National University Hospital Jeju Korea.Departement of Infecti) Oh Hyunjoo (Department of Internal Medicine Jeju National University Hospital Jeju Korea.) Heo Sang Taek (Department of Internal Medicine Jeju National University Hospital Jeju Korea.Department of Internal) Song Sung Wook (Department of Emergency Medicine Jeju National University College of Medicine Jeju Korea.) Lee Keun Hwa (Department of Microbiology Hanyang University College of Medicine Seoul Korea.) Kang Myeong Jin (Department of Nursing Jeju National University Hospital Jeju Korea.) Yoo Jeong Rae (Department of Internal Medicine Jeju National University Hospital Jeju Korea.Department of Internal)

저널정보: 대한감염학회 Infection and Chemotherapy Infection and Chemotherapy 제54권 제3호

발행연도: 2022.9

수록면: 470 - 482 (13page)

DOI: 10.3947/ic.2022.0073

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Background There is a correlation between the severe fever with thrombocytopenia syndrome (SFTS) viral load and disease severity; however, measurement of viral load is difficult in general laboratory and it takes time to obtain a viral load value. Here, the laboratory parameters for predicting the dynamic changes in SFTS viral load were identified. In addition, we tried to evaluate a specific time point for the early determination of clinical deterioration using dynamic change of laboratory parameters. Materials and Methods This observational study included SFTS patients in Korea (2013 - 2020). Cross-correlation analysis at lagged values was used to determine the temporal correlation between the SFTS viral loads and time-series variables. Fifty-eight SFTS patients were included in the non-severe group (NSG) and 11 in the severe group (SG). Results In the cross-sectional analyses, 10 parameters -white blood cell, absolute neutrophil cell, lymphocyte, platelet, activated partial thromboplastin time (aPTT), C-reactive protein, aspartate aminotransferase (AST), alanine transaminase (ALT), lactate dehydrogenase (LDH), and creatine phosphokinase (CPK)- were assessed within 30 days from the onset of symptoms; they exhibited three different correlation patterns: (1) positive, (2) positive with a time lag, and (3) negative. A prediction score system was developed for predicting SFTS fatality based on age and six laboratory variables -platelet, aPTT, AST, ALT, LDH, and CPK- in 5 days after the onset of symptoms; this scoring system had 87.5% sensitivity and 86.0% specificity (95% confidence interval: 0.831 - 1.00, P <0.001). Conclusion Three types of correlation patterns between the dynamic changes in SFTS viral load and laboratory parameters were identified. The dynamic changes in the viral load could be predicted using the dynamic changes in these variables, which can be particularly helpful in clinical settings where viral load tests cannot be performed. Also, the proposed scoring system could provide timely treatment to critical patients by rapidly assessing their clinical course.

Background There is a correlation between the severe fever with thrombocytopenia syndrome (SFTS) viral load and disease severity; however, measurement of viral load is difficult in general laboratory and it takes time to obtain a viral load value. Here, the laboratory parameters for predicting the dynamic changes in SFTS viral load were identified. In addition, we tried to evaluate a specific time point for the early determination of clinical deterioration using dynamic change of laboratory parameters. Materials and Methods This observational study included SFTS patients in Korea (2013 - 2020). Cross-correlation analysis at lagged values was used to determine the temporal correlation between the SFTS viral loads and time-series variables. Fifty-eight SFTS patients were included in the non-severe group (NSG) and 11 in the severe group (SG). Results In the cross-sectional analyses, 10 parameters -white blood cell, absolute neutrophil cell, lymphocyte, platelet, activated partial thromboplastin time (aPTT), C-reactive protein, aspartate aminotransferase (AST), alanine transaminase (ALT), lactate dehydrogenase (LDH), and creatine phosphokinase (CPK)- were assessed within 30 days from the onset of symptoms; they exhibited three different correlation patterns: (1) positive, (2) positive with a time lag, and (3) negative. A prediction score system was developed for predicting SFTS fatality based on age and six laboratory variables -platelet, aPTT, AST, ALT, LDH, and CPK- in 5 days after the onset of symptoms; this scoring system had 87.5% sensitivity and 86.0% specificity (95% confidence interval: 0.831 - 1.00, P <0.001). Conclusion Three types of correlation patterns between the dynamic changes in SFTS viral load and laboratory parameters were identified. The dynamic changes in the viral load could be predicted using the dynamic changes in these variables, which can be particularly helpful in clinical settings where viral load tests cannot be performed. Also, the proposed scoring system could provide timely treatment to critical patients by rapidly assessing their clinical course.

#Severe fever with thrombocytopenia syndrome #Banyangvirus #Tick-borne disease #Fatality prediction #Cross-correlation analysis

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Kim Misun

소속기관 Department of Internal Medicine, Jeju National University Hospital, Jeju, Korea.

주요연구분야 의약학 > 임상의학 > 내과학

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Oh Hyunjoo

소속기관 Department of Internal Medicine, Andong Hospital, Andong, Korea.

주요연구분야 의약학 > 임상의학 > 내과학

논문수 4 이용수 3

Heo Sang Taek

소속기관 Department of Internal Medicine Jeju National University School of Medicine Jeju Korea.

주요연구분야 의약학 > 임상의학 > 내과학

논문수 16 이용수 12

Song Sung Wook

소속기관 Department of Emergency Medicine Jeju National University College of Medicine Jeju Korea.

주요연구분야 의약학 > 임상의학 > 내과학

논문수 1 이용수 1

Lee Keun Hwa

소속기관 Department of Microbiology Hanyang University College of Medicine Seoul Korea.

주요연구분야 의약학 > 임상의학 > 내과학

논문수 3 이용수 1

Kang Myeong Jin

소속기관 Department of Nursing Jeju National University Hospital Jeju Korea.

주요연구분야 의약학 > 임상의학 > 내과학

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Yoo Jeong Rae

소속기관 Division of Infectious Diseases, Department of Internal Medicine, Jeju National University College of Medicine, Jeju, Korea.Department of Internal Medicine, Jeju National University Hospital

주요연구분야 의약학 > 임상의학 > 내과학 의약학 > 임상의학 > 마취과학

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