Table 1. General and Clinical Characteristics of Patients with SFTS in the Non-Fatal and Fatal Groups (2013–2017).
| Non-Fatal | Fatala | Total | |||||
|---|---|---|---|---|---|---|---|
| Characteristics | n = 109 | n = 33 | N = 142 | P Valueb | |||
| Age, years (median, IQR) | 67.0 | (59.0–73.0) | 75.0 | (67.5–81.5) | 68.5 | (61.0–75.3) | < .001 |
| Sex, Male | 57 | (52.3) | 15 | (45.5) | 72 | (50.7) | .554 |
| Comorbidity, total | 64 | (58.7) | 24 | (72.7) | 88 | (62.0) | .146 |
| Initial clinical manifestationc | |||||||
| Fever | 97 | (89.0) | 24 | (77.4) | 121 | (86.4) | .033 |
| Chills | 70 | (64.2) | 11 | (35.5) | 81 | (57.9) | .005 |
| Myalgia | 53 | (48.6) | 7 | (22.6) | 60 | (42.9) | .008 |
| Cough | 10 | (9.2) | 4 | (12.9) | 14 | (10.0) | .492 |
| Nausea | 31 | (28.4) | 7 | (22.6) | 38 | (27.1) | .814 |
| Vomiting | 18 | (16.5) | 7 | (22.6) | 25 | (17.9) | .416 |
| Diarrhea | 31 | (28.4) | 11 | (35.5) | 42 | (30.0) | .366 |
| Altered mental state | 18 | (16.5) | 11 | (35.5) | 29 | (20.7) | .028 |
| Glasgow Coma Scale (median, IQR) | 15.0 | (14.0–15.0) | 15.0 | (11.0–15.0) | 15.0 | (14.0–15.0) | .203 |
| Vital sign at first clinic visit | |||||||
| Body temperature (°C) (median, IQR) | 38.2 | (37.1–38.6) | 38.0 | (37.1–38.7) | 38.0 | (37.1–38.6) | .842 |
| Respiration rate (/min) (median, IQR) | 20.0 | (20.0–20.0) | 20.0 | (20.0–22.0) | 20.0 | (20.0–20.0) | .013 |
| Symptom onset to admission (median days, IQR) | 5.0 | (3.0–7.0) | 4.0 | (3.0–6.0) | 5.0 | (3.0–7.0) | .254 |
| Initial APACHE II score (median, IQR) | 10.0 | (8.0–14.0) | 16.0 | (11.0–20.0) | 11.0 | (9.0–16.0) | < .001 |
| Prior antibiotic treatment | 39 | (36.8) | 16 | (48.5) | 55 | (39.6) | .230 |
| CRRT/hemodialysis | 5 | (4.6) | 11 | (33.3) | 16 | (11.3) | < .001 |
| ICU admission during hospitalization | 34 | (31.5) | 28 | (84.8) | 62 | (44.0) | < .001 |
| Steroids treatment | 35 | (32.1) | 23 | (69.7) | 58 | (40.8) | < .001 |
| Days from admission to first treatment (median, IQR) | 2.0 | (1.0–4.0) | 2.0 | (1.0–3.0) | 2.0 | (1.0–3.3) | .089 |
| Total days of steroids administration (median, IQR) | 5.0 | (3.0–9.0) | 4.0 | (2.0–6.0) | 4.5 | (3.0–7.5) | .077 |
| Steroid dose (median, IQR) d | |||||||
| Dexamethasone (mg/day) | 15.0 | (10.0–16.0) | 15.0 | (10.0–20.0) | 15.0 | (10.0–18.0) | .658 |
| Prednisolone (mg/day) | 20.0 | (10.0-N/A) | 10.0 | N/A | 15.0 | (10.0–20.0) | .500 |
| Methylprednisolone (mg/day) | 125.0 | (57.5–1000.0) | 62.5 | (50.0–125.0) | 68.8 | (56.3–417.5) | .252 |
| Hydrocortisone (mg/day) | 200.0 | (100.0-N/A) | 200.0 | (200.0–300.0) | 200.0 | (200.0–300.0) | .183 |
| Complications, totale | 32 | (29.6) | 30 | (90.9) | 62 | (44.0) | < .001 |
| Meningoencephalitis | 6 | (5.6) | 3 | (9.1) | 9 | (6.4) | .437 |
| Mechanical ventilation | 12 | (11.1) | 21 | (63.6) | 33 | (23.4) | < .001 |
| Arrhythmia | 1 | (0.9) | 7 | (21.2) | 8 | (5.7) | < .001 |
| Pneumonia | 6 | (5.6) | 5 | (15.2) | 11 | (7.8) | .129 |
| Seizure | 3 | (2.8) | 1 | (3.0) | 4 | (2.8) | 1.000 |
| Rhabdomyolysis | 2 | (1.9) | 1 | (3.0) | 3 | (2.1) | .554 |
| MOD | 0 | (0.0) | 1 | (3.0) | 1 | (0.7) | N/A |
| Septic shock/sepsis | 2 | (1.9) | 9 | (27.3) | 11 | (7.8) | < .001 |
| Acute kidney injury | 6 | (5.6) | 6 | (18.2) | 12 | (8.5) | .034 |
| GI bleeding | 2 | (1.9) | 2 | (6.1) | 4 | (2.8) | .233 |
| DIC | 0 | (0.0) | 4 | (12.1) | 4 | (2.8) | N/A |
| Othersf | 7 | (6.5) | 6 | (18.2) | 13 | (9.2) | .078 |
Data are presented as no. (%) unless otherwise indicated. Additional information of general and clinical characteristics of patients with SFTS are provided in the S1 Table.
Abbreviations: APACHE, acute physiology and chronic health evaluation; CRRT, continuous renal replacement therapy; DIC, disseminated intravascular coagulation; GI, gastrointestinal; ICU, intensive care unit; IQR, interquartile range; MOD, multiple organ dysfunction; N/A, not available.
a A total of 29 patients died within 30 days from admission, while 1 patient died after 30 days. Three patients in the fatal group had missing data on 30-day survival time as they died outside of the hospital.
b Analysis using Chi-square test, Fisher’s exact test, or Mann-Whitney U test.
c Missing data: n = 2.
d A total of 23 patients in non-fatal group and 10 patients in fatal group received dexamethasone, 3 in non-fatal and 1 in fatal groups received prednisolone, 9 in non-fatal and 7 in fatal groups received methylprednisolone, and 3 in non-fatal and 7 in fatal groups received hydrocortisone. Of 58 patients who received steroids therapy, five patients received two types of steroid therapy such as dexamethasone plus hydrocortisone or methylprednisolone and methylprednisolone plus prednisolone or hydrocortisone. The dosages and types of steroids prescribed for each patients were different depends on hospitals because there were no guidelines of using steroids in patients with SFTS.
e Missing data: n = 1.
f Other complications included acute cerebral infarction, acute respiratory distress syndrome, aspiration pneumonia, azotemia, infectious mononucleosis, interstitial pulmonary fibrosis, intracranial hemorrhage, lymphadenitis, metabolic encephalopathy, multiple organ failure, pulmonary hemorrhage, respiratory failure, and toxic hepatitis.