Effects of Dexamethasone on Clinical Outcome in Patients with Severe Crimean-Congo Hemorrhagic Fever

Abstract

Background: Crimean-Congo hemorrhagic fever (CCHF) is an acute viral hemorrhagic disease, and it is currently endemic in Southeastern Iran. The present study aimed at comparing the effect of ribavirin alone and in combination with dexamethasone on clinical outcome of patients with severe form of Crimean-Congo hemorrhagic fever. Methods: In this clinical trial study, we studied 30 patients with severe form of Crimean-Congo hemorrhagic fever (2 groups with 14 controls and 16 cases), who were admitted to Boo Ali hospital in Zahedan (Southeast of Iran) from July 2015 to April 2016. Patients were selected randomly for each group. The intervention group received dexamethasone and ribavirin, and the control group was treated only with ribavirin. Then, the rate of recovery, mortality rate, blood products used, and duration of hospitalization in both groups were recorded and compared. The distribution of samples and comparison of quantitative variables were evaluated by Kolmogorov Smirnov test, t test, and Man-Whitney test. The comparison of qualitative variables was performed by Chi-square and McNamara’s test. Results: Of 30 patients, 24 (80%) and 6 (20%) were male and female, respectively. A few patients required transfusion of blood products in the intervention group compared to controls, but there was no statistically significant difference between the 2 groups (P < 0.05). The mean duration of hospitalization was 10.87 and 12 days in the intervention and control groups, respectively. No significant difference was obtained between the 2 groups in the duration of recovery (P < 0.05). No patients died in the intervention and control groups. Conclusions: It seems that high-dose dexamethasone is effective in the treatment of patients with severe form of CCHF. Blood products requirement for severe CCHF patients was reduced after receiving high-dose dexamethasone. Further investigations are necessary to determine the efficacy of corticosteroid and its effect on outcome.