Abstract
BackgroundSevere fever with thrombocytopenia syndrome (SFTS) is an emerging hemorrhagic fever in East Asia, which is caused by a novel bunyavirus-SFTSV. Many studies have reported the clinical characters of SFTS patients, but the reports were not consistent and a systematic summary of clinical manifestations and laboratory parameters are not available.MethodA comprehensive literature research of Web of Science, PubMed, Wan Fang Data, and Chinese National Knowledge Infrastructure databases was conducted on articles which have described the clinical characters of SFTS patients. Data from selected studies were pooled by using STATA VERSION 12.0 software.ResultNine articles comprising 844 laboratory-confirmed SFTSV cases were included in this meta-analysis. The pooled case fatality rate was 16% (95% CI: 0.13–0.19). The major clinical characters of patients with SFTSV infection were fever, thrombocytopenia, leucopenia, gastrointestinal symptoms, and central nervous system manifestations. The risk factors for severe disease included bleeding tendency, central nervous system manifestations, elevated serum enzymes, and high viral load. Although there is no specific antiviral therapy for SFTSV infection, symptomatic treatment and supportive therapy including intensive monitoring is the most essential part of case management.ConclusionThe major clinical characters of patients with SFTSV infection were fever, thrombocytopenia, leucopenia and gastrointestinal symptoms, and central nervous system manifestations. The risk factors for severity and fatality among SFTS patients included: old age, CNS manifestations, bleeding tendency, elevated serum enzymes, and high vial load.
Highlights
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging hemorrhagic fever in East Asia, which is caused by a novel bunyavirus-SFTSV
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging hemorrhagic fever, which was first discovered in rural areas of eastern and central China in 2009 [1] and more recently in South Korea and Japan [2, 3]
Inclusion and exclusion criteria Articles included in this meta-analysis had to meet the following criteria: the first and foremost, the SFTS patient mentioned in the selected studies must be confirmed as meeting one or more of the following criteria: (1) isolated the virus from the patient’s samples, (2) SFTSV RNA was detected from the patient’s serum by a quantitative reverse-transcriptase polymerase chain reaction and (3) a 4-fold or greater increase of antibody titers was detected between a paired serum samples of the patient collected from the acute and convalescent phases of infection; Secondly, the article contained the most recent or largest population was selected when the studies using the same or overlapping data by the same authors
Summary
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging hemorrhagic fever in East Asia, which is caused by a novel bunyavirus-SFTSV. Many studies have reported the clinical characters of SFTS patients, but the reports were not consistent and a systematic summary of clinical manifestations and laboratory parameters are not available. Severe fever with thrombocytopenia syndrome (SFTS) is an emerging hemorrhagic fever, which was first discovered in rural areas of eastern and central China in 2009 [1] and more recently in South Korea and Japan [2, 3]. The major clinical symptoms of SFTS patients included acute fever (temperature of 38 °C or more), thrombocytopenia, leucopenia, gastrointestinal symptoms, and central nervous system (CNS) manifestations, followed with multiple organ dysfunctions [5,6,7,8]. As the fatality rate of this disease was surprisingly high and the main risk factor for
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