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Predictive epidemiological, clinical and laboratory parameters in the diagnosis of Crimean-Congo hemorrhagic fever
Türkkan Ö Kaygusuz1, Ayşe S Tartar1, Şafak Ö Balin1
1Department of Infectious Diseases & Clinical Microbiology, Faculty of Medicine, Fırat University, Elazig, Turkey.
Insights
Predictive laboratory markers can aid in the early diagnosis of Crimean-Congo Hemorrhagic Fever (CCHF). Elevated activated partial thromboplastin time predicts CCHF, while elevated alanine amino transferase, white blood cell count, and C-reactive protein suggest other conditions.
Area of Science:
- Medical Research
- Infectious Diseases
- Clinical Diagnostics
Background:
- Crimean-Congo Hemorrhagic Fever (CCHF) shares clinical and laboratory similarities with other diseases, complicating differential diagnosis.
- Early and accurate diagnosis of CCHF is crucial, especially in endemic regions where advanced testing may be delayed.
Purpose of the Study:
- To identify predictive clinical and laboratory parameters for the differential diagnosis of CCHF.
- To distinguish CCHF from other conditions with overlapping symptoms and test results.
Main Methods:
- A comparative analysis of epidemiological, clinical, and laboratory data from 107 CCHF-positive and 71 CCHF-negative patients.
- Binary logistic regression analysis was employed to identify independent predictors.
Main Results:
- CCHF-positive patients showed significantly higher levels of AST, ALT, CK, LDH, RBC, hemoglobin, and hematocrit.
- CCHF-negative patients had higher levels of total/direct bilirubin, ALP, PT, INR, WBC, CRP, and procalcitonin.
- Activated partial thromboplastin time elevation independently predicted CCHF, while elevated ALT, WBC, and CRP predicted non-CCHF.
Conclusions:
- Specific laboratory parameters can serve as vital predictive markers for the early diagnosis of CCHF in endemic areas.
- Identifying these markers is crucial when PCR and serological tests are not immediately available, facilitating timely clinical management.
Abstract:
Background: The aim of this study is to determine predictive parameters that can be used in the differential diagnosis of Crimean-Congo Hemorrhagic Fever (CCHF) and other diseases with similar clinical and laboratory findings. Materials & methods: In this study, epidemiological, clinical and laboratory parameters of 107 CCHF-positive and 71 CCHF-negative patients were compared. Results: Alanine amino transferase, aspartate aminotransferase, creatine kinase, lactate dehydrogenase, red blood cell, hemoglobin and hematocrit were significantly higher in CCHF-positive patients, whereas total and direct bilirubin, alkaline phosphatase, prothrombin time, international normalization ratio, white blood cell, C-reactive protein and procalcitonin were higher in CCHF-negative patients. In binary logistic regression analysis, an increase in activated partial thromboplastin time level was identified as an independent predictor of having CCHF, while alanine amino transferase, white blood cell and C-reactive protein elevations were identified as independent predictors of not having CCHF. Conclusion: In endemic areas where PCR and serological tests are delayed, knowing the predictive parameters may be of vital importance in the early diagnosis of CCHF.
