Analysis of Changes in Viral Load and Inflammatory Cytokines, as Well as the Occurrence of Secondary Infections, in SFTS Patients Treated with Specific Treatments: A Prospective Multicenter Cohort Study
Severe fever with thrombocytopenia syndrome (SFTS) is an acute febrile illness caused by the SFTS virus (SFTSV). We conducted this study to propose a scientific evidence-based treatment that can improve prognosis through changes in viral load and inflammatory cytokines according to the specific trea...
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2024-12-01
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| author | Jun-Won Seo You Mi Lee Sadia Tamanna Mi-Seon Bang Choon-Mee Kim Da Young Kim Na Ra Yun Jieun Kim Sook In Jung Uh Jin Kim Seong Eun Kim Hyun Ah Kim Eu Suk Kim Jian Hur Young Keun Kim Hye Won Jeong Jung Yeon Heo Dong Sik Jung Hyungdon Lee Sun Hee Park Yee Gyung Kwak Sujin Lee Seungjin Lim Dong-Min Kim |
| author_facet | Jun-Won Seo You Mi Lee Sadia Tamanna Mi-Seon Bang Choon-Mee Kim Da Young Kim Na Ra Yun Jieun Kim Sook In Jung Uh Jin Kim Seong Eun Kim Hyun Ah Kim Eu Suk Kim Jian Hur Young Keun Kim Hye Won Jeong Jung Yeon Heo Dong Sik Jung Hyungdon Lee Sun Hee Park Yee Gyung Kwak Sujin Lee Seungjin Lim Dong-Min Kim |
| author_sort | Jun-Won Seo |
| collection | DOAJ |
| description | Severe fever with thrombocytopenia syndrome (SFTS) is an acute febrile illness caused by the SFTS virus (SFTSV). We conducted this study to propose a scientific evidence-based treatment that can improve prognosis through changes in viral load and inflammatory cytokines according to the specific treatment of SFTS patients. This prospective and observational study was conducted at 14 tertiary referral hospitals, which are located in SFTS endemic areas in Korea, from 1 May 2018 to 31 October 2020. Patients of any age were eligible for inclusion if they were polymerase chain reaction positive against SFTSV, or showed a four-fold or higher increase in IgG antibody titers between two serum samples collected during the acute and convalescent phases. On the other hand, patients with other tick-borne infections were excluded. In total, 79 patients were included in the study. The viral load of the group treated with steroids was 3.39, 3.21, and 1.36 log<sub>10</sub> RNA copies/reaction at each week since the onset of symptoms, and the viral load in patients treated with plasma exchange was 4.47, 2.60, and 2.00 log<sub>10</sub> RNA copies/reaction at each week after symptom onset. The inflammatory cytokines were not reduced effectively by any specific treatment except IVIG for the entire treatment period. Secondary infections according to pathogens revealed four bacterial (26.7%) and one fungal (6.7%) infection in the steroid group. The viral load of SFTSV and inflammatory cytokines cannot be decreased by steroid and plasma exchange treatments. Secondary bacterial infections can occur when steroids are administered for the treatment of SFTS. Therefore, caution should be exercised when choosing treatment strategies for SFTS. |
| format | Article |
| id | doaj-art-bc90e65766c04172bf1e5642ce28b2e2 |
| institution | DOAJ |
| issn | 1999-4915 |
| language | English |
| publishDate | 2024-12-01 |
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| series | Viruses |
| spelling | doaj-art-bc90e65766c04172bf1e5642ce28b2e22025-08-20T02:43:23ZengMDPI AGViruses1999-49152024-12-011612190610.3390/v16121906Analysis of Changes in Viral Load and Inflammatory Cytokines, as Well as the Occurrence of Secondary Infections, in SFTS Patients Treated with Specific Treatments: A Prospective Multicenter Cohort StudyJun-Won Seo0You Mi Lee1Sadia Tamanna2Mi-Seon Bang3Choon-Mee Kim4Da Young Kim5Na Ra Yun6Jieun Kim7Sook In Jung8Uh Jin Kim9Seong Eun Kim10Hyun Ah Kim11Eu Suk Kim12Jian Hur13Young Keun Kim14Hye Won Jeong15Jung Yeon Heo16Dong Sik Jung17Hyungdon Lee18Sun Hee Park19Yee Gyung Kwak20Sujin Lee21Seungjin Lim22Dong-Min Kim23Department of Internal Medicine, College of Medicine, Chosun University, Gwangju 61453, Republic of KoreaDepartment of Internal Medicine, College of Medicine, Chosun University, Gwangju 61453, Republic of KoreaDepartment of Internal Medicine, College of Medicine, Chosun University, Gwangju 61453, Republic of KoreaDepartment of Internal Medicine, College of Medicine, Chosun University, Gwangju 61453, Republic of KoreaPremedical Science, College of Medicine, Chosun University, Gwangju 61453, Republic of KoreaDepartment of Internal Medicine, College of Medicine, Chosun University, Gwangju 61453, Republic of KoreaDepartment of Internal Medicine, College of Medicine, Chosun University, Gwangju 61453, Republic of KoreaDepartment of Internal Medicine, College of Medicine, Hanyang University, Seoul 04763, Republic of KoreaDepartment of Internal Medicine, Chonnam National University Medical School, Gwangju 61469, Republic of KoreaDepartment of Internal Medicine, Chonnam National University Medical School, Gwangju 61469, Republic of KoreaDepartment of Internal Medicine, Chonnam National University Medical School, Gwangju 61469, Republic of KoreaDivision of Infectious Disease, Keimyung University Dongsan Medical Center, Daegu 42601, Republic of KoreaDepartment of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam 13620, Republic of KoreaDepartment of Internal Medicine, Yeungnam University Medical Center, Daegu 42415, Republic of KoreaDepartment of Internal Medicine, Wonju College of Medicine, Yonsei University Wonju, Wonju 26426, Republic of KoreaDepartment of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju 28644, Republic of KoreaDepartment of Infectious Diseases, School of Medicine, Ajou University, Suwon 16499, Republic of KoreaDepartment of Internal Medicine, College of Medicine, Dong-A University, Busan 49201, Republic of KoreaDepartment of Internal Medicine, College of Medicine, Hallym University, Chuncheon 24253, Republic of KoreaDivision of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of KoreaDepartment of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang 10380, Republic of KoreaDepartment of Internal Medicine, College of Medicine, Pusan National University, Yangsan 50612, Republic of KoreaDepartment of Internal Medicine, College of Medicine, Pusan National University, Yangsan 50612, Republic of KoreaDepartment of Internal Medicine, College of Medicine, Chosun University, Gwangju 61453, Republic of KoreaSevere fever with thrombocytopenia syndrome (SFTS) is an acute febrile illness caused by the SFTS virus (SFTSV). We conducted this study to propose a scientific evidence-based treatment that can improve prognosis through changes in viral load and inflammatory cytokines according to the specific treatment of SFTS patients. This prospective and observational study was conducted at 14 tertiary referral hospitals, which are located in SFTS endemic areas in Korea, from 1 May 2018 to 31 October 2020. Patients of any age were eligible for inclusion if they were polymerase chain reaction positive against SFTSV, or showed a four-fold or higher increase in IgG antibody titers between two serum samples collected during the acute and convalescent phases. On the other hand, patients with other tick-borne infections were excluded. In total, 79 patients were included in the study. The viral load of the group treated with steroids was 3.39, 3.21, and 1.36 log<sub>10</sub> RNA copies/reaction at each week since the onset of symptoms, and the viral load in patients treated with plasma exchange was 4.47, 2.60, and 2.00 log<sub>10</sub> RNA copies/reaction at each week after symptom onset. The inflammatory cytokines were not reduced effectively by any specific treatment except IVIG for the entire treatment period. Secondary infections according to pathogens revealed four bacterial (26.7%) and one fungal (6.7%) infection in the steroid group. The viral load of SFTSV and inflammatory cytokines cannot be decreased by steroid and plasma exchange treatments. Secondary bacterial infections can occur when steroids are administered for the treatment of SFTS. Therefore, caution should be exercised when choosing treatment strategies for SFTS.https://www.mdpi.com/1999-4915/16/12/1906severe fever with thrombocytopeniaviral kineticssecondary infection |
| spellingShingle | Jun-Won Seo You Mi Lee Sadia Tamanna Mi-Seon Bang Choon-Mee Kim Da Young Kim Na Ra Yun Jieun Kim Sook In Jung Uh Jin Kim Seong Eun Kim Hyun Ah Kim Eu Suk Kim Jian Hur Young Keun Kim Hye Won Jeong Jung Yeon Heo Dong Sik Jung Hyungdon Lee Sun Hee Park Yee Gyung Kwak Sujin Lee Seungjin Lim Dong-Min Kim Analysis of Changes in Viral Load and Inflammatory Cytokines, as Well as the Occurrence of Secondary Infections, in SFTS Patients Treated with Specific Treatments: A Prospective Multicenter Cohort Study Viruses severe fever with thrombocytopenia viral kinetics secondary infection |
| title | Analysis of Changes in Viral Load and Inflammatory Cytokines, as Well as the Occurrence of Secondary Infections, in SFTS Patients Treated with Specific Treatments: A Prospective Multicenter Cohort Study |
| title_full | Analysis of Changes in Viral Load and Inflammatory Cytokines, as Well as the Occurrence of Secondary Infections, in SFTS Patients Treated with Specific Treatments: A Prospective Multicenter Cohort Study |
| title_fullStr | Analysis of Changes in Viral Load and Inflammatory Cytokines, as Well as the Occurrence of Secondary Infections, in SFTS Patients Treated with Specific Treatments: A Prospective Multicenter Cohort Study |
| title_full_unstemmed | Analysis of Changes in Viral Load and Inflammatory Cytokines, as Well as the Occurrence of Secondary Infections, in SFTS Patients Treated with Specific Treatments: A Prospective Multicenter Cohort Study |
| title_short | Analysis of Changes in Viral Load and Inflammatory Cytokines, as Well as the Occurrence of Secondary Infections, in SFTS Patients Treated with Specific Treatments: A Prospective Multicenter Cohort Study |
| title_sort | analysis of changes in viral load and inflammatory cytokines as well as the occurrence of secondary infections in sfts patients treated with specific treatments a prospective multicenter cohort study |
| topic | severe fever with thrombocytopenia viral kinetics secondary infection |
| url | https://www.mdpi.com/1999-4915/16/12/1906 |
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