title: Concurrent measurement of dynamic changes in viral load, serum enzymes, T cell subsets, and cytokines in patients with severe fever with thrombocytopenia syndrome.
abstract: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infection caused by a novel Bunyavirus. Analysis on the dynamic changes of clinical, laboratory, and immunological abnormalities associated with SFTS in a concurrent study is lacking. Thirty-three SFTS patients were admitted to Jiangsu People's Hospital, Nanjing, China, and diagnosis was made based on the clinical symptoms and positive viral RNA detected by RT-PCR. Four patients deceased and twenty-nine survived. Blood samples were collected every other day between Day 5 and Day 15 from the onset of fever. Samples from healthy volunteers were used as normal controls. Peak viral RNA load, serum enzymes, IL-6, and IL-10 were significantly higher in deceased patients compared to survivors. Viral load, serum enzymes, and cytokines declined in survivors within 2 weeks from onset of fever. CD69+ T cells were elevated early after infection while HLA-DR+ and CTLA4+ T cells were elevated during the recovery phase of those who survived. High level SFTSV viral load was concurrently observed with reduced PLT, elevated serum enzymes, elevated pro-inflammatory and anti-inflammatory cytokines, and activation of CD69+ T cells. The degree and pattern of changes in these parameters may indicate the clinical outcome in SFTSV-infected patients.
authors.affiliation: Department of Infectious Diseases, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China; China-US Vaccine Research Center, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Infectious Diseases, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China.
authors.forename: Yaping
authors.initials: Y
authors.lastname: Han
authors.affiliation: Department of Infectious Diseases, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China.
authors.forename: Yiping
authors.initials: Y
authors.lastname: Xing
authors.affiliation: Department of Infectious Diseases, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China.
authors.forename: Shuang
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Infectious Diseases, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China.
authors.forename: Lianhua
authors.initials: L
authors.lastname: Kong
authors.affiliation: Department of Infectious Diseases, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China.
authors.forename: Yongxiang
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Infectious Diseases, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China.
authors.forename: Lili
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Infectious Diseases, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Liu
authors.affiliation: Department of Infectious Diseases, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Wang
authors.affiliation: China-US Vaccine Research Center, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China; Laboratory of Nucleic Acid Vaccines, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America.
authors.forename: Shixia
authors.initials: S
authors.lastname: Wang
authors.affiliation: China-US Vaccine Research Center, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China; Laboratory of Nucleic Acid Vaccines, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America.
authors.forename: Shan
authors.initials: S
authors.lastname: Lu
authors.affiliation: Department of Infectious Diseases, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China.
authors.forename: Zuhu
authors.initials: Z
authors.lastname: Huang
mesh_terms: D002044:Bunyaviridae Infections / Q000150:complications / Q000276:immunology* / Q000821:virology; D002681:China; D016207:Cytokines / Q000097:blood; D004798:Enzymes / Q000097:blood; D005260:Female; D005334:Fever / Q000150:complications / Q000276:immunology* / Q000821:virology; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D018655:Lymphocyte Count; D008297:Male; D012367:RNA, Viral / Q000302:isolation & purification; D016176:T-Lymphocyte Subsets; D013921:Thrombocytopenia / Q000150:complications / Q000276:immunology* / Q000821:virology; D019562:Viral Load
chemical_list: D016207:Cytokines; D004798:Enzymes; D015850:Interleukin-6; D012367:RNA, Viral; D016753:Interleukin-10