Table 2. General, Clinical Characteristics, and Laboratory Results of Patients with SFTS in the Steroid and Non-Steroid Groups (2013–2017).
| Non-Steroid | Steroid | Total | |||||
|---|---|---|---|---|---|---|---|
| Characteristics | n = 84 | n = 58 | N = 142 | P Valuea | |||
| Age, years (median, IQR) | 67 | (61.0–73.8) | 71.5 | (62.5–77.0) | 68.5 | (61.0–75.3) | .144 |
| Sex, Male | 43 | (51.2) | 29 | (50.0) | 72 | (50.7) | .889 |
| Comorbidity, totalb | 50 | (59.5) | 38 | (65.5) | 88 | (62.0) | .470 |
| Vital sign at first clinic visit | |||||||
| Body temperature (°C) (median, IQR) | 37.9 | (37.1–38.5) | 38.2 | (37.2–38.8) | 38.0 | (37.1–38.6) | .184 |
| SBP (mmHg) (median, IQR) | 116.0 | (107.3–130.0) | 110.0 | (100.0–125.3) | 111.5 | (100.0–128.3) | .033 |
| DBP (mmHg) (median, IQR) | 70.0 | (60.0–77.8) | 65.0 | (60.0–77.3) | 70.0 | (60.0–77.3) | .224 |
| Heart rate (/min) (median, IQR) | 79.0 | (69.0–90.0) | 84.0 | (74.3–92.3) | 80.5 | (70.0–90.0) | .100 |
| Respiration rate (/min) (median, IQR) | 20.0 | (18.0–20.0) | 20.0 | (20.0–22.0) | 20.0 | (20.0–22.0) | .028 |
| Symptom onset to admission (median days, IQR) |
5.0 | (3.0–6.0) | 5.0 | (3.0–5.3) | 5.0 | (3.0–7.0) | .908 |
| Initial APACHE II score (median, IQR) | 10.0 | (8.5–14.0) | 13.0 | (9.0–17.0) | 11 | (9.0–16.0) | .042 |
| Initial clinical manifestationc | |||||||
| Fever | 76 | (91.6) | 45 | (78.9) | 121 | (86.4) | .018 |
| Chills | 54 | (65.1) | 27 | (47.4) | 81 | (57.9) | .033 |
| Myalgia | 42 | (50.6) | 18 | (31.6) | 60 | (42.9) | .038 |
| Gastrointestinald | 55 | (66.3) | 39 | (68.4) | 94 | (67.1) | .709 |
| Central nervous systeme | 40 | (48.2) | 29 | (50.9) | 69 | (49.3) | .887 |
| Glasgow Coma Scale (median, IQR) | 15 | (15–15) | 15 | (13–15) | 15 | (15–15) | .008 |
| Initial laboratory findings | |||||||
| Leukopenia (<4,000/mm3) | 76 | (90.5) | 50 | (86.2) | 126 | (88.7) | .429 |
| Neutropenia (ANC <1,500/mm3) | 52 | (68.4) | 39 | (67.2) | 91 | (67.9) | .885 |
| Lymphopenia (ALC <1500/mm3) | 74 | (96.1) | 57 | (98.3) | 131 | (97.0) | .634 |
| Thrombocytopenia, mild (<150 × 103/mm3) | 81 | (96.4) | 55 | (94.8) | 136 | (95.8) | .688 |
| Anemia (<11 g/dL) | 7 | (8.3) | 4 | (6.9) | 11 | (7.7) | 1.000 |
| Hypoalbuminemia (<3.5 g/dL) | 28 | (38.4) | 27 | (48.2) | 55 | (42.6) | .262 |
| Elevated ALP (>120 IU/L) | 18 | (29.0) | 16 | (31.4) | 34 | (30.1) | .787 |
| Elevated AST (>40 IU/L) | 69 | (84.1) | 46 | (80.7) | 115 | (82.7) | .597 |
| Elevated AST, high (>200 IU/L) | 29 | (35.4) | 22 | (38.6) | 51 | (36.7) | .697 |
| Elevated ALT, (>40 IU/L) | 49 | (59.8) | 36 | (63.2) | 85 | (61.2) | .686 |
| Elevated ALT, high (>200 IU/L) | 11 | (13.4) | 6 | (10.5) | 17 | (12.2) | .609 |
| PT prolongation (INR >1.3) | 3 | (4.2) | 4 | (8.2) | 7 | (5.8) | .442 |
| aPTT prolongation (>40 s) | 46 | (64.8) | 29 | (59.2) | 75 | (62.5) | .533 |
| Elevated CK (>300 IU/L) | 41 | (66.1) | 31 | (81.6) | 72 | (72.0) | .095 |
| Elevated LDH (>300 IU/L) | 47 | (82.5) | 36 | (90.0) | 83 | (85.6) | .298 |
| Elevated CRP (>3 mg/dL) | 9 | (11.8) | 3 | (5.9) | 12 | (9.4) | .359 |
| Prior antibiotic treatment | 28 | (34.6) | 27 | (46.6) | 55 | (39.6) | .154 |
| CRRT/hemodialysis | 5 | (6.0) | 11 | (19.0) | 16 | (11.3) | .016 |
| ICU admission during hospitalization | 23 | (27.7) | 39 | (67.2) | 62 | (44.0) | < .001 |
| Combined treatment | |||||||
| Ribavirin | 14 | (16.7) | 20 | (34.5) | 34 | (23.9) | .014 |
| Plasmapheresis | 10 | (11.9) | 15 | (25.9) | 25 | (17.6) | .032 |
| IVIG | 4 | (4.8) | 25 | (43.1) | 29 | (20.4) | < .001 |
| Steroid dose (median, IQR) f | |||||||
| Dexamethasone (mg/day) | N/A | 15.0 | (10.0–18.0) | 15.0 | (10.0–18.0) | N/A | |
| Prednisolone (mg/day) | N/A | 15.0 | (10.0–20.0) | 15.0 | (10.0–20.0) | N/A | |
| Methylprednisolone (mg/day) | N/A | 68.8 | (56.3–417.5) | 68.8 | (56.3–417.5) | N/A | |
| Hydrocortisone (mg/day) | N/A | 200.0 | (200.0–300.0) | 200.0 | (200.0–300.0) | N/A | |
| Fatality | 10 | (11.9) | 23 | (39.7) | 33 | (23.2) | < .001 |
Data are presented as no. (%) unless otherwise indicated.
Abbreviations: ALC, absolute lymphocyte count; ALP, alkaline phosphatase; ALT, alanine aminotransferase; ANC, absolute neutrophil count; APACHE, acute physiology and chronic health evaluation; aPTT, activated partial thromboplastin time; AST, aspartate aminotransferase; CK, creatinine kinase; CRP, C-reactive protein; CRRT, continuous renal replacement therapy; DIC, disseminated intravascular coagulation; DBP, diastolic blood pressure; G-I, gastro-intestinal; HLH, hemophagocytic lymphohistiocytosis; ICU, intensive care unit; INR, international normalized ratio; IQR, interquartile range; IVIG, intravenous immunoglobulin; LDH, lactate dehydrogenase; MOD, multiple organ dysfunction; N/A, not available; PT, prothrombin time; SBP, systemic blood pressure.
a Analysis using Chi-square test, Fisher’s exact test or Mann-Whitney U test.
b More details of the information are presented in S2 Table.
c Missing data = 2 (non-steroid, n = 1; steroid, n = 1).
d Gastrointestinal symptoms included anorexia, nausea, vomiting, diarrhea, abdominal pain, and abdominal tenderness. More details of the information are presented in S2 Table.
e Central nervous system symptoms included headache, dizziness, neck stiffness, and altered mentation. More details of the information are presented in S2 Table.
f A total of 33 patients received dexamethasone, 4 received prednisolone, 16 received methylprednisolone, and 10 received hydrocortisone. Five patients received two types of steroid therapy such as dexamethasone plus hydrocortisone or methylprednisolone and methylprednisolone plus prednisolone or hydrocortisone.