Eosinophils and basophils in severe fever with thrombocytopenia syndrome patients: Risk factors for predicting the prognosis on admission

Zishuai Liu; Rongling Zhang; Yuanni Liu; Ruize Ma; Ligang Zhang; Zhe Zhao; Ziruo Ge; Xingxiang Ren; Wei Zhang; Ling Lin; Zhihai Chen

doi:10.1371/journal.pntd.0010967

Eosinophils and basophils in severe fever with thrombocytopenia syndrome patients: Risk factors for predicting the prognosis on admission

PLoS Negl Trop Dis. 2022 Dec 21;16(12):e0010967. doi: 10.1371/journal.pntd.0010967. eCollection 2022 Dec.

Authors

Zishuai Liu¹, Rongling Zhang¹, Yuanni Liu², Ruize Ma¹, Ligang Zhang², Zhe Zhao¹, Ziruo Ge¹, Xingxiang Ren¹, Wei Zhang¹, Ling Lin², Zhihai Chen¹

Affiliations

¹ Department of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
² Department of Infectious Diseases, Yantai City Hospital for Infectious Disease, Yantai, China.

Abstract

Background: Severe fever with thrombocytopenia syndrome (SFTS) virus (SFTSV) is an emerging tick-borne phlebovirus with a high fatality rate. Previous studies have demonstrated the poor prognostic role of eosinophils (EOS) and basophils (BAS) in predicting multiple viral infections. This study aimed to explore the role of EOS and BAS in predicting prognosis of patients with SFTS.

Methodology: A total of 194 patients with SFTS who were admitted to Yantai City Hospital from November 2019 to November 2021 were included. Patients' demographic and clinical data were collected. According to the clinical prognosis, they were divided into survival and non-survival groups. Independent risk factors were determined by univariate and multivariate logistic regression analyses.

Findings: There were 171 (88.14%) patients in the survived group and 23 (11.86%) patients in the non-survived group. Patients' mean age was 62.39 ± 11.85 years old, and the proportion of males was 52.1%. Older age, neurological manifestations, hemorrhage, chemosis, and increased levels of laboratory variables, such as EOS% and BAS% on admission, were found in the non-survival group compared with the survival group. EOS%, BAS%, aspartate aminotransferase (AST), direct bilirubin (DBIL), and older age on admission were noted as independent risk factors for poor prognosis of SFTS patients. The combination of the EOS% and BAS% had an area under the curve (AUC) of (0.82; 95% CI: 0.725, 0.932, P = 0.000), which showed an excellent performance in predicting prognosis of patients with SFTS compared with neutrophil-to-lymphocyte ratio (NLR), and both exhibited a satisfactory performance in predicting poor prognosis compared with De-Ritis ratio (AST/alanine aminotransferase (ALT) ratio). EOS% and BAS% were positively correlated with various biomarkers of tissue damage and the incidence of neurological complications in SFTS patients.

Conclusion: EOS% and BAS% are effective predictors of poor prognosis of patients with early-stage SFTS. The combination of EOS% and BAS% was found as the most effective approach.

Copyright: © 2022 Liu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Basophils
Bunyaviridae Infections* / diagnosis
Eosinophils
Humans
Male
Middle Aged
Phlebovirus*
Prognosis
Risk Factors
Severe Fever with Thrombocytopenia Syndrome*

Supplementary concepts

SFTS phlebovirus

Grants and funding

National Natural Science Foundation of China (No. 82072295), Changjiang Scholar Program of Chinese Ministry of Education, and National Key Clinical Specialty Discipline Construction Program for infectious disease of China were awarded to ZC. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.