Prognostic Value of Ratios of Inflammatory Markers in the Prognosis of Crimean–Congo Hemorrhagic Fever
Abstract
:1. Introduction
2. Material and Method
2.1. Study Population
2.2. Laboratory Analysis
2.3. Statistical Analyses
2.4. Ethical Approval
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | Patients (n = 60) | Controls (n = 30) | p-Value |
---|---|---|---|
Age (Years) ± SD | 49.1 ± 15.4 | 47.9 ± 9.3 | 0.648 |
Gender | 0.872 | ||
Male, n (%) | 41 (68.3) | 21 (70) | |
Female, n (%) | 19 (31.7) | 9 (30) | |
Comorbidities | |||
Hypertension | 12 (20.0) | ||
Diabetes mellitus | 6 (10.0) | ||
Coronary artery disease | 4 (6.7) | ||
Chronic obstructive lung disease | 7 (11.7) | ||
Malignancy | 2 (3.3) | ||
Laboratory findings | |||
HGB (g/dL) | 13.8 ± 1.6 | 14.7 ± 1.6 | 0.009 |
PLT (109/L) | 82 (53–112) | 247 (192–272) | <0.001 |
WBC (109/L) | 2.59 (1.6–4.28) | 7.0 (5.9–9.0) | <0.001 |
INR | 1.0 (0.9–1.2) | 1.0 (1.0–1.10) | 0.382 |
aPTT (s) | 32 (29–35) | 29 (26–31) | 0.002 |
D-dimer (mg/L FEU) | 2.2 (0.9–7.03) | 0.2 (0.2–0.2) | <0.001 |
Fibrinogen (mg/dL) | 268 ± 50 | 270 ± 56 | 0.846 |
AST (U/L) | 88 (46–191) | 17 (15–20) | <0.001 |
ALT (U/L) | 53 (26–113) | 18 (13–25) | <0.001 |
GGT (U/L) | 45 (23–95) | 19 (13–29) | <0.001 |
ALP (U/L) | 75 (60–94) | 67 (60–79) | 0.139 |
Creatinine (mg/dL) | 0.8 (0.7–1.0) | 0.8 (0.7–0.9) | 0.196 |
CRP (mg/L) | 12.0 (4.0–35) | 0.95 (0.41–2.16) | <0.001 |
IL-6 (ng/L) | 22 (13–76) | 1.5 (1.5–1.99) | <0.001 |
Treatment, n (%) | |||
Ribavirin | 6 (10.0) | ||
Steroid | 22 (36.7) | ||
Thrombocytes | 28 (46.7) | ||
Fresh frozen plasma | 41 (68.3) | ||
Antibiotics | 20 (33.3) | ||
ICU need, n (%) | 7 (11.7) | ||
Mortality, n (%) | 6 (10.0) |
Variables | Patients (n = 60) | Control (n = 30) | p-Value |
---|---|---|---|
WBC/PLT | 0.03 (0.02–0.05) | 0.03 (0.02–0.04) | 0.909 |
WBC/INR | 2.33 (1.65–3.74) | 7.48 (5.9–8.9) | <0.001 |
WBC/aPTT | 0.08 (0.05–0.12) | 0.26 (0.22–0.33) | <0.001 |
WBC/D-dimer | 0.96 (0.36–2.53) | 35 (29.5–45) | <0.001 |
WBC/Fibrinogen | 0.01 (0.01–0.02) | 0.03 (0.02–0.04) | <0.001 |
WBC/CRP | 0.19 (0.08–0.55) | 6.81 (3.35–17.5) | <0.001 |
WBC/IL-6 | 0.11 (0.04–0.18) | 3.97 (3.38–5.67) | <0.001 |
Laboratory Finding | Non-Fatal Cases (n = 54) | Fatal Cases (n = 6) | p-Value |
---|---|---|---|
HGB (g/dL) | 13.94 ± 1.51 | 12.22 ± 1.79 | 0.012 |
PLT (109/L) | 85 (57–115) | 38 (31–51) | 0.005 |
WBC (109/L) | 2.4 (1.6–3.5) | 6.8 (4.9–9.8) | 0.010 |
INR | 1.0 (0.9–1.1) | 1.5 (1.5–1.6) | <0.001 |
aPTT (s) | 32 (28–35) | 45 (42–64) | <0.001 |
D-dimer (mg/L FEU) | 1.85 (0.81–6.0) | 38.0 (15.0–45.0) | <0.001 |
Fibrinogen (mg/dL) | 273 ± 48 | 226 ± 61 | 0.029 |
CRP (mg/L) | 10.0 (4.0–26.0) | 101 (35–166) | 0.001 |
IL-6 (ng/L) | 18.5 (12.0–53.0) | 314 (79–585) | <0.001 |
WBC/PLT | 0.03 (0.02–0.04) | 0.15 (0.1–0.32) | <0.001 |
WBC/INR | 2.33 (1.6–3.38) | 5.22 (3.27–6.53) | 0.043 |
WBC/aPTT | 0.08 (0.05–0.11) | 0.16 (0.11–0.22) | 0.074 |
WBC/D-dimer | 1.13 (0.5–3.0) | 0.17 (0.11–0.4) | 0.002 |
WBC/Fibrinogen | 0.01 (0.01–0.01) | 0.03 (0.02–0.06) | 0.002 |
WBC/CRP | 0.21 (0.08–0.63) | 0.1 (0.03–0.14) | 0.078 |
WBC/IL-6 | 0.12 (0.04–0.21) | 0.02 (0.02–0.04) | 0.006 |
Variables | ICU Requirement | No Need for ICU | p-Value |
---|---|---|---|
WBC/PLT | 0.16 (0.1–0.32) | 0.03 (0.02–0.04) | <0.001 |
WBC/INR | 6.18 (3.27–6.53) | 2.33 (1.6–3.2) | 0.013 |
WBC/aPTT | 0.19 (0.11–0.22) | 0.08 (0.05–0.11) | 0.026 |
WBC/D-dimer | 0.15 (0.11–0.4) | 1.18 (0.51–3) | 0.001 |
WBC/Fibrinogen | 0.03 (0.02–0.06) | 0.01 (0.01–0.01) | <0.001 |
WBC/CRP | 0.09 (0.03–0.14) | 0.21 (0.08–0.63) | 0.061 |
WBC/IL-6 | 0.02 (0.02–0.05) | 0.12 (0.04–0.21) | 0.006 |
Variables | Cut-Off Value | AUC | Sensitivity (95% CI) | Specificity (95% CI) | LR (+) (95% CI) | LR (−) (95% CI) | p-Value |
---|---|---|---|---|---|---|---|
WBC/PLT | ≤0.045 | 0.512 | 71.7 (58.6–82.5) | 0 (0–11.6) | 0.72 (0.61–0.84) | NA | 0.835 |
WBC/INR | ≤3.5 | 0.923 | 73.3 (60.3–83.9) | 100 (88.4–100) | NA | 0.27 (0.18–0.41) | <0.001 |
WBC/APTT | ≤0.12 | 0.917 | 78.3 (65.8–87.9) | 96.7 (82.8–99.9) | 23.5 (3.41–162) | 0.22 (0.14–0.36) | <0.001 |
WBC/D-dimer | ≤11.1 | 0.990 | 98.3 (91.1–100) | 100 (88.4–100) | NA | 0.017 (0.002–0.12) | <0.001 |
WBC/Fibrinogen | ≤0.017 | 0.886 | 81.7 (69.6–90.5) | 90.0 (73.5–97.9) | 8.17 (2.77–24.1) | 0.20 (0.12–0.35) | <0.001 |
WBC/CRP | ≤2.1 | 0.980 | 95.0 (86.1–99.0) | 96.7 (82.8–99.9) | 28.5 (4.15–196) | 0.052 (0.017–0.16) | <0.001 |
WBC/IL-6 | ≤0.53 | 0.998 | 96.7 (88.5–99.6) | 100 (88.4–100) | NA | 0.033 (0.009–0.13) | <0.001 |
Variables | Cut-Off Value | AUC | Sensitivity (95% CI) | Specificity (95% CI) | LR (+) (95% CI) | LR (−) (95% CI) | p-Value |
---|---|---|---|---|---|---|---|
WBC/PLT | >0.064 | 0.969 | 100 (54.1–100) | 92.6 (82.1–97.9) | 13.5 (5.26–34.7) | 0 | <0.001 |
WBC/INR | >3.2 | 0.753 | 83.3 (35.9–99.6) | 74.1 (60.3–85.0) | 3.21 (1.81–5.72) | 0.23 (0.037–1.36) | 0.061 |
WBC/APTT | >0.106 | 0.722 | 83.3 (35.9–99.6) | 74.1 (60.3–85.0) | 3.21 (1.81–5.72) | 0.23 (0.037–1.36) | 0.096 |
WBC/D-dimer | ≤0.45 | 0.867 | 100 (54.1–100) | 75.9 (62.4–86.5) | 4.15 (2.59–6.67) | 0 | <0.001 |
WBC/Fibrinogen | >0.017 | 0.880 | 83.3 (35.9–99.6) | 88.9 (77.4–95.8) | 7.5 (3.25–17.3) | 0.19 (0.031–1.12) | <0.001 |
WBC/CRP | ≤0.14 | 0.722 | 83.3 (35.9–99.6) | 63.0 (48.7–75.7) | 2.25 (1.37–3.71) | 0.26 (0.044–1.60) | 0.028 |
WBC/IL-6 | ≤0.036 | 0.830 | 83.3 (35.9–99.6) | 81.5 (68.6–90.7) | 4.5 (2.32–8.74) | 0.2 (0.034–1.23) | <0.001 |
Variables | Cut-Off Value | AUC | Sensitivity (95% CI) | Specificity (95% CI) | LR (+) (95% CI) | LR (−) (95% CI) | p-Value |
---|---|---|---|---|---|---|---|
WBC/PLT | >0.064 | 0.984 | 100 (59.0–100) | 94.3 (84.3–98.8) | 17.7 (5.89–53.0) | 0 | <0.001 |
WBC/INR | >3.2 | 0.784 | 85.7 (42.1–99.6) | 75.5 (61.7–86.2) | 3.49 (1.99–6.12) | 0.19 (0.031–1.17) | 0.017 |
WBC/APTT | >0.106 | 0.757 | 85.7 (42.1–99.6) | 75.5 (61.7–86.2) | 3.49 (1.99–6.12) | 0.19 (0.031–1.17) | 0.030 |
WBC/D-dimer | ≤0.45 | 0.879 | 100 (59.0–100) | 77.4 (63.8–87.7) | 4.42 (2.69–7.26) | 0 | <0.001 |
WBC/Fibrinogen | >0.017 | 0.903 | 85.7 (42.1–99.6) | 90.6 (79.3–96.9) | 9.09 (3.74 22.1) | 0.16 (0.026–0.97) | <0.001 |
WBC/CRP | ≤0.14 | 0.720 | 85.7 (42.1–99.6) | 64.2 (49.8–76.9) | 2.39 (1.49–3.83) | 0.22 (0.036–1.38) | 0.014 |
WBC/IL-6 | ≤0.048 | 0.814 | 85.7 (42.1–99.6) | 71.7 (57.7–83.2) | 3.03 (1.79–5.12) | 0.2 (0.032–1.23) | <0.001 |
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Hasbek, M.; Kıymaz, Y.Ç.; Büyüktuna, S.A.; Yavuz, H. Prognostic Value of Ratios of Inflammatory Markers in the Prognosis of Crimean–Congo Hemorrhagic Fever. Trop. Med. Infect. Dis. 2025, 10, 99. https://doi.org/10.3390/tropicalmed10040099
Hasbek M, Kıymaz YÇ, Büyüktuna SA, Yavuz H. Prognostic Value of Ratios of Inflammatory Markers in the Prognosis of Crimean–Congo Hemorrhagic Fever. Tropical Medicine and Infectious Disease. 2025; 10(4):99. https://doi.org/10.3390/tropicalmed10040099
Chicago/Turabian StyleHasbek, Mürşit, Yasemin Çakır Kıymaz, Seyit Ali Büyüktuna, and Hayrettin Yavuz. 2025. "Prognostic Value of Ratios of Inflammatory Markers in the Prognosis of Crimean–Congo Hemorrhagic Fever" Tropical Medicine and Infectious Disease 10, no. 4: 99. https://doi.org/10.3390/tropicalmed10040099
APA StyleHasbek, M., Kıymaz, Y. Ç., Büyüktuna, S. A., & Yavuz, H. (2025). Prognostic Value of Ratios of Inflammatory Markers in the Prognosis of Crimean–Congo Hemorrhagic Fever. Tropical Medicine and Infectious Disease, 10(4), 99. https://doi.org/10.3390/tropicalmed10040099