Effects of steroid therapy in patients with severe fever with Thrombocytopenia syndrome: A multicenter clinical cohort study

Background Severe fever with thrombocytopenia syndrome (SFTS) is an acute, febrile, and potentially fatal tick-borne disease caused by the SFTS Phlebovirus. Here, we evaluated the effects of steroid therapy in Korean patients with SFTS. Methods A retrospective study was performed in a multicenter SF...

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Published in:PLoS Neglected Tropical Diseases 2021, Vol.15 (2)
Main Authors: Jung, Sook In, Kim, Ye Eun, Yun, Na Ra, Kim, Choon-Mee, Kim, Dong-Min, Han, Mi Ah, Kim, Uh Jin, Kim, Seong Eun, Kim, Jieun, Ryu, Seong Yeol, Kim, Hyun ah, Hur, Jian, Kim, Young Keun, Jeong, Hye Won, Heo, Jung Yeon, Jung, Dong Sik, Lee, Hyungdon, Huh, Kyungmin, Kwak, Yee Gyung, Lee, Sujin, Lim, Seungjin, Lee, Sun Hee, Park, Sun Hee, Yeom, Joon-Sup, Kim, Shin-Woo, Bae, In-Gyu, Lee, Juhyung, Kim, Eu Suk, Seo, Jun-Won
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Language:English
Subjects:
Development and progression
Drug therapy
Patient outcomes
Steroids (Drugs)
Thrombocytopenia
Tick-borne diseases
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container_title PLoS Neglected Tropical Diseases
container_volume 15
creator Jung, Sook In
Kim, Ye Eun
Yun, Na Ra
Kim, Choon-Mee
Kim, Dong-Min
Han, Mi Ah
Kim, Uh Jin
Kim, Seong Eun
Kim, Jieun
Ryu, Seong Yeol
Kim, Hyun ah
Hur, Jian
Kim, Young Keun
Jeong, Hye Won
Heo, Jung Yeon
Jung, Dong Sik
Lee, Hyungdon
Huh, Kyungmin
Kwak, Yee Gyung
Lee, Sujin
Lim, Seungjin
Lee, Sun Hee
Park, Sun Hee
Yeom, Joon-Sup
Kim, Shin-Woo
Bae, In-Gyu
Lee, Juhyung
Kim, Eu Suk
Seo, Jun-Won
description Background Severe fever with thrombocytopenia syndrome (SFTS) is an acute, febrile, and potentially fatal tick-borne disease caused by the SFTS Phlebovirus. Here, we evaluated the effects of steroid therapy in Korean patients with SFTS. Methods A retrospective study was performed in a multicenter SFTS clinical cohort from 13 Korean university hospitals between 2013 and 2017. We performed survival analysis using propensity score matching of 142 patients with SFTS diagnosed by genetic or antibody tests. Results Overall fatality rate was 23.2%, with 39.7% among 58 patients who underwent steroid therapy. Complications were observed in 37/58 (63.8%) and 25/83 (30.1%) patients in the steroid and non-steroid groups, respectively (P < .001). Survival analysis after propensity score matching showed a significant difference in mean 30-day survival time between the non-steroid and steroid groups in patients with a mild condition [Acute Physiology and Chronic Health Evaluation II (APACHE II) score 5 days), and non-steroid groups, were 18.4, 22.4, and 27.3 days, respectively (P = .005). Conclusions After steroid therapy, an increase in complications was observed among patients with SFTS. Steroid therapy should be used with caution, considering the possible negative effects of steroid therapy within 5 days of symptom onset or in patients with mild disease (APACHE II score
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Here, we evaluated the effects of steroid therapy in Korean patients with SFTS. Methods A retrospective study was performed in a multicenter SFTS clinical cohort from 13 Korean university hospitals between 2013 and 2017. We performed survival analysis using propensity score matching of 142 patients with SFTS diagnosed by genetic or antibody tests. Results Overall fatality rate was 23.2%, with 39.7% among 58 patients who underwent steroid therapy. Complications were observed in 37/58 (63.8%) and 25/83 (30.1%) patients in the steroid and non-steroid groups, respectively (P &lt; .001). Survival analysis after propensity score matching showed a significant difference in mean 30-day survival time between the non-steroid and steroid groups in patients with a mild condition [Acute Physiology and Chronic Health Evaluation II (APACHE II) score 5 days), and non-steroid groups, were 18.4, 22.4, and 27.3 days, respectively (P = .005). Conclusions After steroid therapy, an increase in complications was observed among patients with SFTS. Steroid therapy should be used with caution, considering the possible negative effects of steroid therapy within 5 days of symptom onset or in patients with mild disease (APACHE II score &lt;14).</description><identifier>ISSN: 1935-2727</identifier><identifier>DOI: 10.1371/journal.pntd.0009128</identifier><language>eng</language><publisher>Public Library of Science</publisher><subject>Development and progression ; Drug therapy ; Patient outcomes ; Steroids (Drugs) ; Thrombocytopenia ; Tick-borne diseases</subject><ispartof>PLoS Neglected Tropical Diseases, 2021, Vol.15 (2)</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>776,780,4476,27902</link.rule.ids></links><search><creatorcontrib>Jung, Sook In</creatorcontrib><creatorcontrib>Kim, Ye Eun</creatorcontrib><creatorcontrib>Yun, Na Ra</creatorcontrib><creatorcontrib>Kim, Choon-Mee</creatorcontrib><creatorcontrib>Kim, Dong-Min</creatorcontrib><creatorcontrib>Han, Mi Ah</creatorcontrib><creatorcontrib>Kim, Uh Jin</creatorcontrib><creatorcontrib>Kim, Seong Eun</creatorcontrib><creatorcontrib>Kim, Jieun</creatorcontrib><creatorcontrib>Ryu, Seong Yeol</creatorcontrib><creatorcontrib>Kim, Hyun ah</creatorcontrib><creatorcontrib>Hur, Jian</creatorcontrib><creatorcontrib>Kim, Young Keun</creatorcontrib><creatorcontrib>Jeong, Hye Won</creatorcontrib><creatorcontrib>Heo, Jung Yeon</creatorcontrib><creatorcontrib>Jung, Dong Sik</creatorcontrib><creatorcontrib>Lee, Hyungdon</creatorcontrib><creatorcontrib>Huh, Kyungmin</creatorcontrib><creatorcontrib>Kwak, Yee Gyung</creatorcontrib><creatorcontrib>Lee, Sujin</creatorcontrib><creatorcontrib>Lim, Seungjin</creatorcontrib><creatorcontrib>Lee, Sun Hee</creatorcontrib><creatorcontrib>Park, Sun Hee</creatorcontrib><creatorcontrib>Yeom, Joon-Sup</creatorcontrib><creatorcontrib>Kim, Shin-Woo</creatorcontrib><creatorcontrib>Bae, In-Gyu</creatorcontrib><creatorcontrib>Lee, Juhyung</creatorcontrib><creatorcontrib>Kim, Eu Suk</creatorcontrib><creatorcontrib>Seo, Jun-Won</creatorcontrib><title>Effects of steroid therapy in patients with severe fever with Thrombocytopenia syndrome: A multicenter clinical cohort study</title><title>PLoS Neglected Tropical Diseases</title><description>Background Severe fever with thrombocytopenia syndrome (SFTS) is an acute, febrile, and potentially fatal tick-borne disease caused by the SFTS Phlebovirus. Here, we evaluated the effects of steroid therapy in Korean patients with SFTS. Methods A retrospective study was performed in a multicenter SFTS clinical cohort from 13 Korean university hospitals between 2013 and 2017. We performed survival analysis using propensity score matching of 142 patients with SFTS diagnosed by genetic or antibody tests. Results Overall fatality rate was 23.2%, with 39.7% among 58 patients who underwent steroid therapy. Complications were observed in 37/58 (63.8%) and 25/83 (30.1%) patients in the steroid and non-steroid groups, respectively (P &lt; .001). Survival analysis after propensity score matching showed a significant difference in mean 30-day survival time between the non-steroid and steroid groups in patients with a mild condition [Acute Physiology and Chronic Health Evaluation II (APACHE II) score 5 days), and non-steroid groups, were 18.4, 22.4, and 27.3 days, respectively (P = .005). Conclusions After steroid therapy, an increase in complications was observed among patients with SFTS. Steroid therapy should be used with caution, considering the possible negative effects of steroid therapy within 5 days of symptom onset or in patients with mild disease (APACHE II score &lt;14).</description><subject>Development and progression</subject><subject>Drug therapy</subject><subject>Patient outcomes</subject><subject>Steroids (Drugs)</subject><subject>Thrombocytopenia</subject><subject>Tick-borne diseases</subject><issn>1935-2727</issn><fulltext>true</fulltext><rsrctype>report</rsrctype><creationdate>2021</creationdate><recordtype>report</recordtype><sourceid/><recordid>eNqVjU1OwzAUhL0AifJzAxbvAg12IjcNuwoVcYDukbGfyascv8h2QJE4PEZwATSLkb6Z0Qhxr2Sjul49nHlJ0YRmjsU1UspBtfsLsVFDp7dt3_ZX4jrns5R60Hu1EV9H79GWDOwhF0xMDsqIycwrUITZFMJY408qI2T8wITgf-yXnMbE0xvbtfCMkQzkNbqK8BEOMC2hkK3z2raBIlkTwPLIqdSvxa234tKbkPHuz29E83w8Pb1s303AV4qeSzK2yuFEliN6qvyw03on-27ou38PvgFL-WBh</recordid><startdate>20210219</startdate><enddate>20210219</enddate><creator>Jung, Sook In</creator><creator>Kim, Ye Eun</creator><creator>Yun, Na Ra</creator><creator>Kim, Choon-Mee</creator><creator>Kim, Dong-Min</creator><creator>Han, Mi Ah</creator><creator>Kim, Uh Jin</creator><creator>Kim, Seong Eun</creator><creator>Kim, Jieun</creator><creator>Ryu, Seong Yeol</creator><creator>Kim, Hyun ah</creator><creator>Hur, Jian</creator><creator>Kim, Young Keun</creator><creator>Jeong, Hye Won</creator><creator>Heo, Jung Yeon</creator><creator>Jung, Dong Sik</creator><creator>Lee, Hyungdon</creator><creator>Huh, Kyungmin</creator><creator>Kwak, Yee Gyung</creator><creator>Lee, Sujin</creator><creator>Lim, Seungjin</creator><creator>Lee, Sun Hee</creator><creator>Park, Sun Hee</creator><creator>Yeom, Joon-Sup</creator><creator>Kim, Shin-Woo</creator><creator>Bae, In-Gyu</creator><creator>Lee, Juhyung</creator><creator>Kim, Eu Suk</creator><creator>Seo, Jun-Won</creator><general>Public Library of Science</general><scope/></search><sort><creationdate>20210219</creationdate><title>Effects of steroid therapy in patients with severe fever with Thrombocytopenia syndrome: A multicenter clinical cohort study</title><author>Jung, Sook In ; 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Here, we evaluated the effects of steroid therapy in Korean patients with SFTS. Methods A retrospective study was performed in a multicenter SFTS clinical cohort from 13 Korean university hospitals between 2013 and 2017. We performed survival analysis using propensity score matching of 142 patients with SFTS diagnosed by genetic or antibody tests. Results Overall fatality rate was 23.2%, with 39.7% among 58 patients who underwent steroid therapy. Complications were observed in 37/58 (63.8%) and 25/83 (30.1%) patients in the steroid and non-steroid groups, respectively (P &lt; .001). Survival analysis after propensity score matching showed a significant difference in mean 30-day survival time between the non-steroid and steroid groups in patients with a mild condition [Acute Physiology and Chronic Health Evaluation II (APACHE II) score 5 days), and non-steroid groups, were 18.4, 22.4, and 27.3 days, respectively (P = .005). Conclusions After steroid therapy, an increase in complications was observed among patients with SFTS. Steroid therapy should be used with caution, considering the possible negative effects of steroid therapy within 5 days of symptom onset or in patients with mild disease (APACHE II score &lt;14).</abstract><pub>Public Library of Science</pub><doi>10.1371/journal.pntd.0009128</doi></addata></record>
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source Publicly Available Content Database; PubMed Central
subjects Development and progression
Drug therapy
Patient outcomes
Steroids (Drugs)
Thrombocytopenia
Tick-borne diseases
title Effects of steroid therapy in patients with severe fever with Thrombocytopenia syndrome: A multicenter clinical cohort study
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