Prognostic Factors of Severe Fever with Thrombocytopenia Syndrome in South Korea

Abstract

Severe fever with thrombocytopenia syndrome (SFTS), a tick-borne infectious disease, is difficult to differentiate from other common febrile diseases. Clinically distinctive features and climate variates associated with tick growth can be useful predictors for SFTS. This retrospective study (2013-2019) demonstrated the role of climatic factors as predictors of SFTS and developed a clinical scoring system for SFTS using climate variables and clinical characteristics. The presence of the SFTS virus was confirmed using reverse transcription polymerase chain reaction (RT-PCR) tests. In the univariate analysis, the SFTS-positive group was significantly associated with higher mean ambient temperature and humidity compared with the SFTS-negative group (22.5 degrees C vs. 18.9 degrees C; 77.9% vs. 70.7%, all p < 0.001). In the multivariate analysis, poor oral intake (Odds ratio [OR] 5.87, 95% CI: 2.42-8.25), lymphadenopathy (OR 7.20, 95% CI: 6.24-11.76), mean ambient temperature >= 20 degrees C (OR 4.62, 95% CI: 1.46-10.28), absolute neutrophil count <= 2000 cells/mu L (OR 8.95, 95% CI: 2.30-21.25), C-reactive protein level <= 1.2 mg/dL (OR 6.42, 95% CI: 4.02-24.21), and creatinine kinase level >= 200 IU/L (OR 5.94, 95% CI: 1.42-24.92) were significantly associated with the SFTS-positive group. This study presents the risk factors, including ambient temperature and clinical characteristics, that physicians should consider when suspecting SFTS.