Clinical analysis of patients with severe fever with thrombocytopenia syndrome bunyavirus infection and hemorrhagic fever with renal syndrome

Abstract

Objective To compare the differences of epidemiology, clinical characteristics, laboratory results and prognosis between patients with severe fever with thrombocytopenia syndrome bunyavirus (SFTSV) infection and those with hemorrhagic fever with renal syndrome (HFRS). Methods Medical records of 16 hospitalized cases with SFTSV infection and 28 hospitalized HFRS cases from January 2012 to June 2016 were reviewed in affiliated Yijishan Hospital of Wannan Medical College. In details, the comparative analysis of patients between the two groups were conducted in sex, age, occupation, onset season, contact history, underlying diseases, fever duration, oliguria, bleeding (including petechiae, ecchymoses, gum bleeding, bloody stool and hematuria), secondary infection, consciousness disturbance, dialysis treatment, length of hospital stay, laboratory results and prognosis. Continuous variables of normal, non-normal distribution data were compared using two-sample t test and rank sum test, respectively. Categorical variables were showed in rate and compared using chi-square test. Results The differences between the two groups in age (t=2.585), occupation (χ2=4.914), onset season (χ2=4.325) and contact history (χ2=9.617) were all statistically significant (all P<0.05). In SFTSV infection group, the mean fever duration was (8.81±3.17) d. There were 2 cases of oliguria, 10 cases of bleeding, 7 cases of secondary infection, 5 cases of consciousness disturbance. No patient received dialysis. The average length of hospital stay was (13.44±7.91) d. In HFRS group, the mean fever duration was (5.96±2.20) d. In addition, there were 24 cases of oliguria, 25 cases of bleeding, 9 cases of secondary infection, 3 cases of consciousness disorder. Twelve cases received dialysis treatment in this group. The average length of hospital stay was (18.04±15.75) d. Furthermore, there were significant differences between the two groups in fever duration (t=3.511), oliguria (χ2=22.578), bleeding (χ2=4.490) and dialysis (χ2=7.392) (all P<0.05). The significant differences were also found in white blood cell count, blood urea nitrogen, serum creatinine, albumin, amylase, lipase, creatine kinase, serum sodium, chloride, calcium, carbon dioxide combining power and blood glucose between the SFTSV infection group and HFRS group (all P<0.05). However, there was no significant difference in prognosis between the two groups (Z=1.574, P=0.115). Conclusions There are differences in epidemiological history, clinical manifestations and laboratory findings between the SFTSV infection group and HFRS group, which may help differential diagnosis and treatment of these two diseases. Key words: Severe fever with thrombocytopenia syndrome bunyavirus; Hemorrhagic fever with renal syndrome; Clinical characteristic; Case analysis