Abstract
Background/aimCrimean-Congo hemorrhagic fever (CCHF) is a serious illness characterized by fever and hemorrhage. Endothelin-1 (ET-1), angiopoietin-2 (Ang-2), and endothelial cell-specific receptor tyrosine kinase (Tie-2) are believed to be important markers of the pathogenesis, clinical course, and prognosis of the disease. The aim of this study was to determine ET-1, Ang-2, and Tie-2 levels in adults with CCHF and investigate the associations between these markers and pathogenesis and disease course.Materials and methodsSixty CCHF patients were included in the study. The patients were classified according to disease severity criteria and Ang-2, Tie-2, and ET-1 levels were compared.ResultsMean serum ET-1 level was 36.62 ± 27.99 pg/mL in the patient group and 3.70 ± 4.71 pg/mL in the control group (P = 0.001). Mean serum Ang-2 levels were 2511.18 ± 1018.64 pg/mL in the patient group and 3570.76 ± 209.52 pg/mL in the control group (P = 0.001). Mean serum Tie-2 levels were 7.35 ± 7.75 ng/mL in the patient group and 0.67 ± 1.26 ng/mL in the control group (P = 0.001). ConclusionElevated ET-1 and Tie-2 levels were associated with more severe disease course, while Ang-2 level was negatively correlated with severity in adult CCHF patients. ET-1, Tie-2, and Ang-2 levels are important prognostic parameters in CCHF and may contribute significantly to treatment and follow-up.
Highlights
Elevated ET-1 and Tie-2 levels were associated with more severe disease course, while Ang-2 level was negatively correlated with severity in adult Crimean-Congo hemorrhagic fever (CCHF) patients
Crimean-Congo hemorrhagic fever (CCHF) is a serious illness that occurs each year in spring and summer in endemic regions
Study groups The patients were divided into those with mild-moderate disease and those with severe disease according to the criteria defined by Swanepoel et al and the modified criteria recommended by Ergönül et al [7,8], as well as the clinical indicators of poor prognosis
Summary
Crimean-Congo hemorrhagic fever (CCHF) is a serious illness that occurs each year in spring and summer in endemic regions. It presents with fever and hemorrhage, and in severe cases can lead to shock and death. The coagulation and fibrinolysis that develop in CCHF manifest clinically as petechiae, ecchymosis, mucosal hemorrhage, and uncontrollable hemorrhage at venous puncture sites. Endothelial cells, and hepatocytes are the main target cells in CCHF. Macrophage activation and hemophagocytosis are likely pathological processes. The resulting vascular damage induces clotting dysfunction and increased capillary permeability, which result in hemorrhagic tendency. Inflammatory mediators play an important role in fatal cases [1,2]
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