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

Abstract

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.

Keywords

• Lactate
• Crimean–Congo hemorrhagic fever
• procalcitonin

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

Abstract

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.

Keywords

• Laktat
• Kırım-Kongo hemorajik ateş
• prokalsitonin

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