Ferritin, CRP and D-Dimer Significantly Predicts Outcome Of Crimean-Congo Hemorrhagic Fever But Procalcitonin Does Not

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Barut H. S. , Demir O., Gunes F., Duygu F., Gemici U., KOSTAKOĞLU U.

7.EACID2015, Tiflis, Georgia, 30 September - 03 October 2015, pp.330-331

  • Publication Type: Conference Paper / Full Text
  • City: Tiflis
  • Country: Georgia
  • Page Numbers: pp.330-331


Several prognostic markers of Crimean Congo Hemorrhagic Fever (CCHF) have been established to date. This study was done to
find whether C-reactive protein (CRP), procalcitonin (PCT), d-dimer or ferritin were important as a prognostic marker.
This retrospective study was conducted in a tertiary care hospital which is placed in an hyperendemic area, Tokat, Turkey. In the
period of March 2014-September 2014, confirmed cases of CCHF who were hospitalized in the infectious diseases clinic, included
in the study. Confirmation was based on laboratory detection of CCHF virus spesific IgM by enzymed linked immunosorbant assay
(ELISA) and/or by detection of nucleic acid of CCHF virus by reverse transcription polymerase chain reaction. Some demographic
features and laboratory findings were analyzed in order to determine prognostic markers.
One hundred and thirtysix patients were included, 13 of them died. Age and gender were not associated with fatality. Ferritin and
CRP levels on admission in fatal cases were significantly higher than survived ones (p=0.01 and p<0.001 respectively) (table 1).
D-dimer values on admission were also more increased in fatal cases (p<0.001), but PCT on admission or following days was not
found to be related to mortality (Table 1). Other laboratory markers, tested on admission, which were associated with mortality, were
as follows. Increased white blood cell count (WBC), decreased platelet count and fibrinogen levels, increased activities of aspartate
aminotransferase (AST), alanine aminotransferase (ALT), creatine phosphokinase (CK), lactate dehydrogenase (LDH), prolonged
international normalized ratio (INR) and activated partial thromboplastin time (aPTT) (table 1). CRP was better correlated with
d-dimer, INR on admission and the highest aPTT during hospital stay (r=0.605, r=0.66, r=0.53 respectively). Ferritin on admission
was found to be best correlated with d-dimer, AST (on admission or following), platelet count, LDH, and aPTT on admission (r=0.55,
r=0.571, r=0.58, r=0.717, r=0.59 respectively).
Beyond known predictors of mortality, it was a new finding of this study that CRP, d-dimer and ferritin on admission were higher in
fatal cases than survived ones. CRP was slightly increased in survived cases while it was moderately increased in fatal cases, thus we
can use this new markers to estimate the prognosis.,