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Viral and Immunologic Factors Associated with Fatal Outcome of Patients with Severe Fever with Thrombocytopenia Syndrome in Korea

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Abstract
Significant progress has been made on the molecular biology of the severe fever with thrombopenia virus (SFTSV); however, many parts of the pathophysiological mechanisms of mortality in SFTS remain unclear. In this study, we investigated virologic and immunologic factors for fatal outcomes of patients with SFTS. We prospectively enrolled SFTS patients admitted from July 2015 to October 2020. Plasma samples were subjected to SFTSV RNA RT-PCR, multiplex microbead immunoassay for 17 cytokines, and IFA assay. A total of 44 SFTS patients were enrolled, including 37 (84.1%) survivors and 7 (15.9%) non-survivors. Non-survivors had a 2.5 times higher plasma SFTSV load than survivors at admission (p < 0.001), and the viral load in non-survivors increased progressively during hospitalization. In addition, non-survivors did not develop adequate anti-SFTSV IgG, whereas survivors exhibited anti-SFTSV IgG during hospitalization. IFN-α, IL-10, IP-10, IFN-γ, IL-6, IL-8, MCP-1, MIP-1α, and G-CSF were significantly elevated in non-survivors compared to survivors and did not revert to normal ranges during hospitalization (p < 0.05). Severe signs of inflammation such as a high plasma concentration of IFN-α, IL-10, IP-10, IFN-γ, IL-6, IL-8, MCP-1, MIP-1α, and G-CSF, poor viral control, and inadequate antibody response during the disease course were associated with mortality in SFTS patients.
Author(s)
권지수기선호김다사랑김민재김민철김성한김양수김지연김태은라상현박성연박세윤이근화이상오이현정정용필진솔차혜희최상호
Issued Date
2021
Type
Article
Keyword
chemokinescytokinesfatal outcomehumoral immunitySFTS phlebovirus
DOI
10.3390/v13122351
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8328
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_doaj_primary_oai_doaj_org_article_c35797cf6a1d4857a5cde673b4b76a61&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Viral%20and%20Immunologic%20Factors%20Associated%20with%20Fatal%20Outcome%20of%20Patients%20with%20Severe%20Fever%20with%20Thrombocytopenia%20Syndrome%20in%20Korea&amp;offset=0&amp;pcAvailability=true
Publisher
Viruses-Basel
Location
스위스
Language
한국어
ISSN
1999-4915
Citation Volume
13
Citation Number
12
Citation Start Page
2351
Citation End Page
2351
Appears in Collections:
Medicine > Medicine
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