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The Association Between Procalcitonin, Lactate Level, and Clinical Prognosis in Patients with Crimean-Congo Hemorrhagic Fever

Yıl 2021, Cilt: 23 Sayı: 3, 299 - 304, 30.12.2021

Ferhan Kerget Buğra Kerget Sibel İba Yılmaz

https://doi.org/10.18678/dtfd.1012774
Cited By: 2

Öz

Aim: Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic infection characterized by fever and hemorrhage that is endemic to northeastern Turkey. This study aimed to examine the association between procalcitonin and venous blood gas parameters and clinical course and prognosis in patients with CCHF.
Material and Methods: A total of 96 CCHF patients who were followed up in the infectious diseases department between March 2020 and September 2020 were included in the study. The patients’ routine laboratory tests, serum procalcitonin, and results of venous blood gas analysis were analyzed retrospectively.
Results: There were statistically significant differences in serum platelet, aspartate transaminase, alanine transaminase, creatinine kinase, lactate dehydrogenase, potassium, C-reactive protein, sedimentation, D-dimer, activated partial thromboplastin time, ferritin, procalcitonin and lactate levels, and platelet/lymphocyte ratio among the patients with mild, moderate and severe disease (p=0.017 for potassium, p=0.004 for D-dimer, and p<0.001 for rest of others). In receiver operating characteristic curve analysis of serum lactate for the differentiation of patients with severe disease and those with mild/moderate disease, the area under curve was 0.802 and a cut-off value of 1.9 mmol/L had 77.8% sensitivity and 76.9% specificity. For serum procalcitonin, the area under curve was 0.892 and a cut-off value of 0.61 ng/mL had 83.3% sensitivity and 89.7% specificity.
Conclusion: Serum procalcitonin and lactate level may be useful and easily obtained parameters to guide the evaluation of clinical severity and follow-up in patients with CCHF.

Anahtar Kelimeler

Lactate Crimean–Congo hemorrhagic fever procalcitonin

Kaynakça

  • Karti SS, Odabasi Z, Korten V, Yilmaz M, Sonmez M, Caylan R, et al. Crimean-Congo hemorrhagic fever in Turkey. Emerg Infect Dis. 2004;10(8):1379-84.
  • Leblebicioglu H, Ozaras R, Fletcher TE, Beeching NJ; ESCMID Study Group for Infections in Travellers and Migrants (ESGITM). Crimean-Congo haemorrhagic fever in travellers: A systematic review. Travel Med Infect Dis. 2016;14(2):73-80.
  • Nasirian H. Crimean-Congo hemorrhagic fever (CCHF) seroprevalence: A systematic review and meta-analysis. Acta Trop. 2019;196:102-20.
  • Akıncı E, Bodur H, Leblebicioglu H. Pathogenesis of Crimean-Congo hemorrhagic fever. Vector Borne Zoonotic Dis. 2013;13(7):429-37.
  • Demirtas E, Bakir M, Buyuktuna SA, Oksuz C, Oz M, Cebecioglu K, et al. Comparison of the predictive performance of qSOFA, APACHE II and SGS for evaluation of the disease prognosis of CCHF patients at the emergency department. Jpn J Infect Dis. 2020:73(5):323-9.
  • Mazza BF, Machado FR, Mazza DD, Hassmann V. Evaluation of blood transfusion effects on mixed venous oxygen saturation and lactate levels in patients with SIRS/sepsis. Clinics (Sao Paulo). 2005;60(4):311-6.
  • Goyal M, Pines JM, Drumheller BC, Gaieski DF. Point-of-care testing at triage decreases time to lactate level in septic patients. J Emerg Med. 2010;38(5):578-81.
  • Foushee JA, Hope NH, Grace EE. Applying biomarkers to clinical practice: a guide for utilizing procalcitonin assays. J Antimicrob Chemother. 2012;67(11):2560-9.
  • Swanepoel R, Gill DE, Shepherd AJ, Leman PA, Mynhardt JH, Harvey S. The clinical pathology of Crimean-Congo hemorrhagic fever. Rev Infect Dis. 1989;11(Suppl 4):S794-800.
  • Ergönül Ö, Şeref C, Eren Ş, Çelikbaş A, Baykam N, Dokuzoğuz B, et al. Cytokine response in Crimean-Congo hemorrhagic fever virus infection. J Med Virol. 2017;89(10):1707-13.
  • Kilinc C, Gückan R, Capraz M, Varol K, Zengin E, Mengeloglu Z, et al. Examination of the specific clinical symptoms and laboratory findings of Crimean-Congo hemorrhagic fever. J Vector Borne Dis. 2016;53(2):162-7.
  • Qaderi S, Mardani M, Shah A, Shah J, Bazgir N, Sayad J, et al. Crimean-Congo hemorrhagic fever (CCHF) in Afghanistan: A retrospective single center study. Int J Infect Dis. 2021;103:323-8.
  • Burt FJ, Swanepoel R, Shieh WJ, Smith JF, Leman PA, Greer PW, et al. Immunohistochemical and in situ localization of Crimean-Congo hemorrhagic fever (CCHF) virus in human tissues and implications for CCHF pathogenesis. Arch Pathol Lab Med. 1997;121(8):839-46.
  • Kerget F, Özkurt Z, Öztürk N, Yilmaz S. The relationship with clinical course and prognosis of serum endothelin-1, angiopoietin-2, and tie-2 levels in Crimean-Congo hemorrhagic fever. Turk J Med Sci. 2019;49(4):1192-7.
  • Shahhosseini N, Wong G, Babuadze G, Camp JV, Ergonul O, Kobinger GP, et al. Crimean-Congo hemorrhagic fever virus in Asia, Africa and Europe. Microorganisms. 2021;9(9):1907.
  • Ergonul O, Tuncbilek S, Baykam N, Celikbas A, Dokuzoguz B. Evaluation of serum levels of interleukin (IL)-6, IL-10, and tumor necrosis factor-alpha in patients with Crimean-Congo hemorrhagic fever. J Infect Dis. 2006;193(7):941-4.
  • Ergönül Ö. Crimean-Congo haemorrhagic fever. Lancet Infect Dis. 2006;6(4):203-14.
  • Kerget F, Demirdöğen ŞO, Kerget B. Case report: A rare case of Crimean-Congo hemorrhagic fever associated with epididymo-orchitis. Am J Trop Med Hyg. 2021;104(3):1055-7.
  • Luft D, Deichsel G, Schmulling RM, Stein W, Eggstein M. Definition of clinically relevant lactic acidosis in patients with internal diseases. Am J Clin Pathol. 1983;80(4):484-9.
  • Kruse O, Grunnet N, Barfod C. Blood lactate as a predictor for in-hospital mortality in patients admitted acutely to hospital: a systematic review. Scand J Trauma Resusc Emerg Med. 2011;19:74.
  • Bakker J, Postelnicu R, Mukherjee V. Lactate: where are we now? Crit Care Clin. 2020;36(1):115-24.
  • Simon L, Gauvin F, Amre DK, Saint-Louis P, Lacroix J. Serum procalcitonin and C-reactive protein levels as markers of bacterial infection: a systematic review and meta-analysis. Clin Infect Dis. 2004;39(2):206-17.
  • Hamade B, Huang DT. Procalcitonin: where are we now? Crit Care Clin. 2020;36(1):23-40.
  • Gul S, Ozturk DB, Kisa U, Kacmaz B, Yesilyurt M. Procalcitonin levels and their predictive effect on mortality in Crimean-Congo hemorrhagic fever patients. Jpn J Infect Dis. 2015;68(6):511-3.

Kırım-Kongo Kanamalı Ateşi Hastalarında Prokalsitonin ve Laktat Düzeyinin Klinik Seyirle İlişkisi

Yıl 2021, Cilt: 23 Sayı: 3, 299 - 304, 30.12.2021

Ferhan Kerget Buğra Kerget Sibel İba Yılmaz

https://doi.org/10.18678/dtfd.1012774
Cited By: 2

Öz

Amaç: Kırım-Kongo kanamalı ateşi (KKKA) ateş ve kanama ile seyreden Türkiye’nin Kuzeydoğusunda endemik olarak gözlenen zoonotik bir enfeksiyondur. Bu çalışmada KKKA hastalarında prokalsitonin ve venöz kan gazı parametrelerinin klinik seyir ve prognoz ile ilişkisinin incelenmesi amaçlanmıştır.
Gereç ve Yöntemler: Mart 2020 ve Eylül 2020 tarihleri arasında enfeksiyon hastalıkları kliniğinde takip edilen toplam 96 KKKA hastası çalışmaya dahil edildi. Hastaların rutin laboratuvar tetkikleri, serum prokalsitonin ve venöz kan gazı analizi bulguları geriye dönük olarak analiz edildi.
Bulgular: Hafif, orta ve ağır hastalığı olan hastalar arasındaki serum trombosit, aspartat transaminaz, alanin transaminaz, kreatinin kinaz, laktat dehidrojenaz, potasyum, C-reaktif protein, sedimantasyon, D-dimer, aktive parsiyel tromboplastin zamanı, ferritin, prokalsitonin ve laktat seviyeleri ve trombosit/lenfosit açısından istatistiksel olarak anlamlı farklılıklar vardı (potasyum için p=0,017; D-Dimer için p=0,004 ve geri kalan diğerleri için p<0,001). Ağır hastalığı olan ve hafif/orta hastalığı olan hastaların ayrımı için serum laktat düzeyinin alıcı işlem karakteristiği eğrisi analizinde, eğri altında kalan alan 0,802 idi ve kesim değeri 1.9 mmol/L alındığında %77,8 duyarlılığa ve %76,9 özgüllüğe sahipti. Serum prokalsitonin için eğri altında kalan alan 0,892 idi ve 0.61 ng/mL'lik bir kesim değeri alındığında %83,3 duyarlılık ve %89,7 özgüllüğe sahipti.
Sonuç: Serum prokalsitonin ve laktat düzeyi KKKA hastalarında klinik şiddetin değerlendirilmesinde ve takipte yol gösterici olması açısından yararlı ve kolay elde edilen parametreler olabilirler.

Anahtar Kelimeler

Laktat Kırım-Kongo hemorajik ateş prokalsitonin

Kaynakça

  • Karti SS, Odabasi Z, Korten V, Yilmaz M, Sonmez M, Caylan R, et al. Crimean-Congo hemorrhagic fever in Turkey. Emerg Infect Dis. 2004;10(8):1379-84.
  • Leblebicioglu H, Ozaras R, Fletcher TE, Beeching NJ; ESCMID Study Group for Infections in Travellers and Migrants (ESGITM). Crimean-Congo haemorrhagic fever in travellers: A systematic review. Travel Med Infect Dis. 2016;14(2):73-80.
  • Nasirian H. Crimean-Congo hemorrhagic fever (CCHF) seroprevalence: A systematic review and meta-analysis. Acta Trop. 2019;196:102-20.
  • Akıncı E, Bodur H, Leblebicioglu H. Pathogenesis of Crimean-Congo hemorrhagic fever. Vector Borne Zoonotic Dis. 2013;13(7):429-37.
  • Demirtas E, Bakir M, Buyuktuna SA, Oksuz C, Oz M, Cebecioglu K, et al. Comparison of the predictive performance of qSOFA, APACHE II and SGS for evaluation of the disease prognosis of CCHF patients at the emergency department. Jpn J Infect Dis. 2020:73(5):323-9.
  • Mazza BF, Machado FR, Mazza DD, Hassmann V. Evaluation of blood transfusion effects on mixed venous oxygen saturation and lactate levels in patients with SIRS/sepsis. Clinics (Sao Paulo). 2005;60(4):311-6.
  • Goyal M, Pines JM, Drumheller BC, Gaieski DF. Point-of-care testing at triage decreases time to lactate level in septic patients. J Emerg Med. 2010;38(5):578-81.
  • Foushee JA, Hope NH, Grace EE. Applying biomarkers to clinical practice: a guide for utilizing procalcitonin assays. J Antimicrob Chemother. 2012;67(11):2560-9.
  • Swanepoel R, Gill DE, Shepherd AJ, Leman PA, Mynhardt JH, Harvey S. The clinical pathology of Crimean-Congo hemorrhagic fever. Rev Infect Dis. 1989;11(Suppl 4):S794-800.
  • Ergönül Ö, Şeref C, Eren Ş, Çelikbaş A, Baykam N, Dokuzoğuz B, et al. Cytokine response in Crimean-Congo hemorrhagic fever virus infection. J Med Virol. 2017;89(10):1707-13.
  • Kilinc C, Gückan R, Capraz M, Varol K, Zengin E, Mengeloglu Z, et al. Examination of the specific clinical symptoms and laboratory findings of Crimean-Congo hemorrhagic fever. J Vector Borne Dis. 2016;53(2):162-7.
  • Qaderi S, Mardani M, Shah A, Shah J, Bazgir N, Sayad J, et al. Crimean-Congo hemorrhagic fever (CCHF) in Afghanistan: A retrospective single center study. Int J Infect Dis. 2021;103:323-8.
  • Burt FJ, Swanepoel R, Shieh WJ, Smith JF, Leman PA, Greer PW, et al. Immunohistochemical and in situ localization of Crimean-Congo hemorrhagic fever (CCHF) virus in human tissues and implications for CCHF pathogenesis. Arch Pathol Lab Med. 1997;121(8):839-46.
  • Kerget F, Özkurt Z, Öztürk N, Yilmaz S. The relationship with clinical course and prognosis of serum endothelin-1, angiopoietin-2, and tie-2 levels in Crimean-Congo hemorrhagic fever. Turk J Med Sci. 2019;49(4):1192-7.
  • Shahhosseini N, Wong G, Babuadze G, Camp JV, Ergonul O, Kobinger GP, et al. Crimean-Congo hemorrhagic fever virus in Asia, Africa and Europe. Microorganisms. 2021;9(9):1907.
  • Ergonul O, Tuncbilek S, Baykam N, Celikbas A, Dokuzoguz B. Evaluation of serum levels of interleukin (IL)-6, IL-10, and tumor necrosis factor-alpha in patients with Crimean-Congo hemorrhagic fever. J Infect Dis. 2006;193(7):941-4.
  • Ergönül Ö. Crimean-Congo haemorrhagic fever. Lancet Infect Dis. 2006;6(4):203-14.
  • Kerget F, Demirdöğen ŞO, Kerget B. Case report: A rare case of Crimean-Congo hemorrhagic fever associated with epididymo-orchitis. Am J Trop Med Hyg. 2021;104(3):1055-7.
  • Luft D, Deichsel G, Schmulling RM, Stein W, Eggstein M. Definition of clinically relevant lactic acidosis in patients with internal diseases. Am J Clin Pathol. 1983;80(4):484-9.
  • Kruse O, Grunnet N, Barfod C. Blood lactate as a predictor for in-hospital mortality in patients admitted acutely to hospital: a systematic review. Scand J Trauma Resusc Emerg Med. 2011;19:74.
  • Bakker J, Postelnicu R, Mukherjee V. Lactate: where are we now? Crit Care Clin. 2020;36(1):115-24.
  • Simon L, Gauvin F, Amre DK, Saint-Louis P, Lacroix J. Serum procalcitonin and C-reactive protein levels as markers of bacterial infection: a systematic review and meta-analysis. Clin Infect Dis. 2004;39(2):206-17.
  • Hamade B, Huang DT. Procalcitonin: where are we now? Crit Care Clin. 2020;36(1):23-40.
  • Gul S, Ozturk DB, Kisa U, Kacmaz B, Yesilyurt M. Procalcitonin levels and their predictive effect on mortality in Crimean-Congo hemorrhagic fever patients. Jpn J Infect Dis. 2015;68(6):511-3.
Toplam 24 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Araştırma Makalesi
Yazarlar

Ferhan Kerget 0000-0002-5160-4854

Buğra Kerget 0000-0002-6048-1462

Sibel İba Yılmaz 0000-0002-4123-0828

Yayımlanma Tarihi 30 Aralık 2021
Gönderilme Tarihi 20 Ekim 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 23 Sayı: 3

Kaynak Göster

APA Kerget, F., Kerget, B., & İba Yılmaz, S. (2021). The Association Between Procalcitonin, Lactate Level, and Clinical Prognosis in Patients with Crimean-Congo Hemorrhagic Fever. Duzce Medical Journal, 23(3), 299-304. https://doi.org/10.18678/dtfd.1012774
AMA Kerget F, Kerget B, İba Yılmaz S. The Association Between Procalcitonin, Lactate Level, and Clinical Prognosis in Patients with Crimean-Congo Hemorrhagic Fever. Duzce Med J. Aralık 2021;23(3):299-304. doi:10.18678/dtfd.1012774
Chicago Kerget, Ferhan, Buğra Kerget, ve Sibel İba Yılmaz. “The Association Between Procalcitonin, Lactate Level, and Clinical Prognosis in Patients With Crimean-Congo Hemorrhagic Fever”. Duzce Medical Journal 23, sy. 3 (Aralık 2021): 299-304. https://doi.org/10.18678/dtfd.1012774.
EndNote Kerget F, Kerget B, İba Yılmaz S (01 Aralık 2021) The Association Between Procalcitonin, Lactate Level, and Clinical Prognosis in Patients with Crimean-Congo Hemorrhagic Fever. Duzce Medical Journal 23 3 299–304.
IEEE F. Kerget, B. Kerget, ve S. İba Yılmaz, “The Association Between Procalcitonin, Lactate Level, and Clinical Prognosis in Patients with Crimean-Congo Hemorrhagic Fever”, Duzce Med J, c. 23, sy. 3, ss. 299–304, 2021, doi: 10.18678/dtfd.1012774.
ISNAD Kerget, Ferhan vd. “The Association Between Procalcitonin, Lactate Level, and Clinical Prognosis in Patients With Crimean-Congo Hemorrhagic Fever”. Duzce Medical Journal 23/3 (Aralık 2021), 299-304. https://doi.org/10.18678/dtfd.1012774.
JAMA Kerget F, Kerget B, İba Yılmaz S. The Association Between Procalcitonin, Lactate Level, and Clinical Prognosis in Patients with Crimean-Congo Hemorrhagic Fever. Duzce Med J. 2021;23:299–304.
MLA Kerget, Ferhan vd. “The Association Between Procalcitonin, Lactate Level, and Clinical Prognosis in Patients With Crimean-Congo Hemorrhagic Fever”. Duzce Medical Journal, c. 23, sy. 3, 2021, ss. 299-04, doi:10.18678/dtfd.1012774.
Vancouver Kerget F, Kerget B, İba Yılmaz S. The Association Between Procalcitonin, Lactate Level, and Clinical Prognosis in Patients with Crimean-Congo Hemorrhagic Fever. Duzce Med J. 2021;23(3):299-304.

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