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Prognostic Factors in CCHF - An Indian Origin Study.

Rahul M Gambhir¹, Mahesh M Rathod²

¹Associate Professor, PDU Government Medical College, Rajkot, Gujarat.

The Journal of the Association of Physicians of India

|December 6, 2019

Summary

Crimean-Congo hemorrhagic fever (CCHF) is a severe tick-borne illness. In Indian patients, prolonged APTT, elevated INR, ALT, and low fibrinogen levels predict CCHF fatality.

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Area of Science:

Epidemiology of emerging infectious diseases
Viral hemorrhagic fevers
Zoonotic disease research

Background:

Crimean-Congo hemorrhagic fever (CCHF) is an emerging zoonotic viral hemorrhagic illness in India.
The disease has high mortality and significant potential for nosocomial spread.
CCHF cases have been reported in Gujarat and Rajasthan, India, since 2011.

Purpose of the Study:

To re-evaluate predictors of fatality in confirmed cases of CCHF in an Indian setting.
To compare clinical and laboratory parameters between survived and deceased CCHF patients.

Main Methods:

Retrospective and observational study design.
Inclusion of 12 RT-PCR confirmed CCHF cases (8 survivors, 4 deaths).
Comparison of clinical and laboratory parameters between survivor and non-survivor groups.

Main Results:

Significant differences observed in activated partial thromboplastin time (APTT) prolongation, elevated INR, ALT levels, and decreased serum fibrinogen.
CCHF IgM positivity, major bleeding symptoms, and central nervous system (CNS) involvement were more frequent in non-survivors.
No significant differences noted in platelet count, total white blood cell (WBC) count, or other clinical parameters.

Conclusions:

APTT prolongation, INR elevation, ALT level, low S.Fibrinogen, CCHF IgM positivity, major bleeding, and CNS involvement are potential predictors of fatality in Indian CCHF patients.
Further research with larger sample sizes is required to validate these findings in the Indian population.