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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.
Insights
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.
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.
Background And Objectives:
CCHF is an emerging zoonotic Viral haemorrhagic illness in indian setup after dengue and KFD. It is known for its high mortality and high potential for nosocomial spread. After detection of the first confirmed case from Ahmedabad-Gujarat in 2011, there are so many cases detected from other area of Gujarat and Nearby Rajasthan state. Several studies have been performed to anticipate the severity of the disease from other countries where it is already an endemic disease. Aim of our study is to re-evaluate the predictors of fatality in confirmed cases of CCHF.
Methods:
In our retrospective and observational study, total 12 (Twelve) RT- PCR confirmed cases were included. Out of that, 8 (eight) patients survived while 4 (four) patients died. We compared clinical and laboratory parameters among survived and died. Because of small sample size, no appropriate statistical method can be used.
Results And Conclusion:
Marked difference noted between two groups in Aptt prolongation, INR elevation, ALT level, S.Fibrinogen, CCHF IgM positivity, major bleeding symptoms and CNS involvement while no such major difference seen in other parameters like platelet count, total WBC count and other clinical parameters. Further study with large sample size from indian patients needed to confirm above findings.
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