Clinical characteristics and prognostic factors of 25 patients with new bunyavirus infection

Objective To investigate the clinical characteristics and prognostic factors of patients with the new type of bunyavirus infection. Methods A total of 25 patients with new bunyavirus infection diagnosed in Jinhua area between August 2011 and December 2017 were selected. According to their survival, 25 patients were divided into the cure group (15 cases) and death group (10 cases). The general data, symptoms and signs, laboratory tests including the leucocyte count, neutrophile granulocyte, hemoglobin, platelet count, total bilirubin, direct bilirubin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), AST/ALT, troponin I, lactic dehydrogenase, creatine kinase, creatine kinase isoenzyme (CK-MB), prothrombin time (PT), activated partial thromboplastin time (APTT), D-dimer, creatinine, and urinary protein, treatment and prognosis were compared between the cure group and death group, and the related factors of prognosis were analyzed using the receiver operating characteristic (ROC) curve. Results Patients with consciousness disorder in the cure group were significantly fewer than those in the death group (1/15 vs. 7/10, P=0.002). The AST/ALT [1.80 (1.38, 3.16) vs. 3.27 (1.97, 4.84), H=1.997, P=0.046], troponin I [0.04 (0.02, 0.25) ng/L vs. 0.63 (0.49, 1.19) ng/L, H=3.328, P=0.001], creatine kinase [836.00 (318.00, 1 462.00) U/L vs. 2 486.00 (590.25, 3 417.00) U/L, H=2.302, P=0.021], CK-MB [33.00 (25.00, 52.00) U/L vs. 66.50 (38.25, 104.50) U/L, H=1.970, P=0.049], PT [11.70 (10.90, 12.20) s vs. 14.35 (12.53, 15.63) s, H=2.719, P=0.007] and APTT [44.70 (34.20, 53.20) s vs. 79.00 (60.05, 105.55) s, H=3.439, P=0.001] in the cure group were also significantly lower than those in the death group. AST/ALT, troponin I, creatine kinase, CK-MB, PT and APTT were included in the ROC analysis. The results showed that AST/ALT [area under the curve (AUC)=0.740, 95% confidence interval (CI) (0.525, 0.955), P=0.046], troponin I [AUC=0.900, 95% CI (0.777, 0.987), P=0.001], creatine kinase [AUC=0.777, 95%CI (0.570, 0.983), P=0.021], CK-MB [AUC=0.737, 95%CI (0.519, 0.954), P=0.049], PT [AUC=0.817, 95%CI (0.654, 0.923), P=0.007] and APTT [AUC=0.913, 95%CI (0.804, 0.993), P=0.001] had predictive value for the prognosis of patients with the new type of bunyavirus infection. The AUCs of troponin I and APTT were 0.900 and 0.913, respectively, both of which can predict prognosis. Conclusions In Jinhua area, patients infected with the new type of bunyavirus had more serious illnesses, high mortality and various clinical symptoms. Among them, AST/ALT, troponin I, creatine kinase, CK-MB, PT and APTT are important prognostic factors. Key words: Fever with thrombocytopenia syndrome; New type of bunyavirus; Tick; Prognosis