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Correlation between thrombocytopenia and host response in severe fever with thrombocytopenia syndrome.
- Source :
-
PLoS neglected tropical diseases [PLoS Negl Trop Dis] 2020 Oct 29; Vol. 14 (10), pp. e0008801. Date of Electronic Publication: 2020 Oct 29 (Print Publication: 2020). - Publication Year :
- 2020
-
Abstract
- Severe Fever with Thrombocytopenia Syndrome (SFTS) is an emerging infectious disease caused by a novel bunyavirus, SFTS virus (SFTSV), with fatal outcome developed in approximately 17% of the cases. Thrombocytopenia is a hallmark feature of SFTS, and associated with a higher risk of fatal outcome, however, the pathophysiological involvement of platelet in the clinical outcome of SFTS remained under-investigated. In the current study, by retrospectively analyzing 1538 confirmed SFTS patients, we observed that thrombocytopenia was associated with enhanced activation of the cytokine network and the vascular endothelium, also with a disturbed coagulation response. The platelet phenotypes were also extensively altered in the process of thrombocytopenia development of SFTS patients. More importantly, all these disturbed host responses were related to the severity of thrombocytopenia, thus were considered to play in a synergistic way to influence the disease outcome. Moreover, the clinical effect of platelet transfusion was assessed by comparing two groups of patients with or without receiving this therapy. As a result, we observed no therapy effect in altering frequencies of fatal outcome, clinical bleeding development, or dynamic change of platelet count during the hospitalization. It's suggested that platelet supplementation alone acted a minor role in improving disease outcome, therefore new therapeutic intervention to regulate host response should be proposed. The current results revealed some evidence of interrelationship between platelet count and clinical outcome of SFTS disease from the perspective of activation of the cytokine network, the vascular endothelium, and the coagulation/fibrinolysis system. These evaluations might help to attain a better understanding of the pathogenesis and therapy choice in SFTS.<br />Competing Interests: The authors have declared that no competing interests exist.
- Subjects :
- Adult
Aged
Cytokines blood
Female
Humans
Male
Middle Aged
Phlebovirus
Platelet Count
Retrospective Studies
Severe Fever with Thrombocytopenia Syndrome blood
Severe Fever with Thrombocytopenia Syndrome mortality
Severe Fever with Thrombocytopenia Syndrome virology
Thrombocytopenia blood
Thrombocytopenia mortality
Thrombocytopenia virology
Severe Fever with Thrombocytopenia Syndrome diagnosis
Thrombocytopenia diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1935-2735
- Volume :
- 14
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- PLoS neglected tropical diseases
- Publication Type :
- Academic Journal
- Accession number :
- 33119592
- Full Text :
- https://doi.org/10.1371/journal.pntd.0008801