title: Epidemiological and clinical characteristics of severe fever with thrombocytopenia syndrome (SFTS) in China: an integrated data analysis.
abstract: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease that was caused by a novel bunyavirus, SFTSV. The study aimed to disclose the epidemiological and clinical characteristics of SFTSV infection in China so far. An integrated clinical database comprising 1920 SFTS patients was constructed by combining first-hand clinical information collected from SFTS sentinel hospitals (n = 1159) and extracted data (n = 761) from published literature. The considered variables comprised clinical manifestations, routine laboratory tests of acute infection, hospitalization duration and disease outcome. SFTSV-IgG data from 19 119 healthy subjects were extracted from the published papers. The key clinical variables, case-fatality rate (CFR) and seroprevalence were estimated by meta-analysis. The most commonly seen clinical manifestations of SFTSV infection were fever, anorexia, myalgia, chill and lymphadenopathy. The major laboratory findings were elevated lactate dehydrogenase, aminotransferase, followed by thrombocytopenia, lymphocytopenia, elevated alanine transaminase and creatine kinase. A CFR of 12·2% was estimated, significantly higher than that obtained from national reporting data, but showing no geographical difference. In our paper, the mortality rate was about 1·9 parts per million. Older age and longer delay to hospitalization were significantly associated with fatal outcome. A pooled seroprevalence of 3·0% was obtained, which increased with age, while comparable for gender. This study represents a clinical characterization on the largest group of SFTS patients up to now. A higher than expected CFR was obtained. A wider spectrum of clinical index was suggested to be used to identify SFTSV infection, while the useful predictor for fatal outcome was found to be restricted.
authors.affiliation: State Key Laboratory of Pathogen and Biosecurity,Beijing Institute of Microbiology and Epidemiology,Beijing,P.R. China.
authors.forename: C-T
authors.initials: CT
authors.lastname: Guo
authors.affiliation: School of Public Health,Peking University,Beijing,P.R. China.
authors.forename: Q-B
authors.initials: QB
authors.lastname: Lu
authors.affiliation: Department for Virus Infectious Diseases Control and Prevention,Shandong Center for Disease Control and Prevention,Shandong Provincial Key Laboratory of Communicable,Disease Control and Prevention,Jinan,Shandong,P.R. China.
authors.forename: S-J
authors.initials: SJ
authors.lastname: Ding
authors.affiliation: State Key Laboratory of Pathogen and Biosecurity,Beijing Institute of Microbiology and Epidemiology,Beijing,P.R. China.
authors.forename: C-Y
authors.initials: CY
authors.lastname: Hu
authors.affiliation: State Key Laboratory of Pathogen and Biosecurity,Beijing Institute of Microbiology and Epidemiology,Beijing,P.R. China.
authors.forename: J-G
authors.initials: JG
authors.lastname: Hu
authors.affiliation: State Key Laboratory of Pathogen and Biosecurity,Beijing Institute of Microbiology and Epidemiology,Beijing,P.R. China.
authors.forename: Y
authors.initials: Y
authors.lastname: Wo
authors.affiliation: State Key Laboratory of Pathogen and Biosecurity,Beijing Institute of Microbiology and Epidemiology,Beijing,P.R. China.
authors.forename: Y-D
authors.initials: YD
authors.lastname: Fan
authors.affiliation: Department for Virus Infectious Diseases Control and Prevention,Shandong Center for Disease Control and Prevention,Shandong Provincial Key Laboratory of Communicable,Disease Control and Prevention,Jinan,Shandong,P.R. China.
authors.forename: X-J
authors.initials: XJ
authors.lastname: Wang
authors.affiliation: The 154 Hospital,People's Liberation Army,Xinyang,P.R. China.
authors.forename: S-L
authors.initials: SL
authors.lastname: Qin
authors.affiliation: The 154 Hospital,People's Liberation Army,Xinyang,P.R. China.
authors.forename: N
authors.initials: N
authors.lastname: Cui
authors.affiliation: The 154 Hospital,People's Liberation Army,Xinyang,P.R. China.
authors.forename: Z-D
authors.initials: ZD
authors.lastname: Yang
authors.affiliation: State Key Laboratory of Pathogen and Biosecurity,Beijing Institute of Microbiology and Epidemiology,Beijing,P.R. China.
authors.forename: X-A
authors.initials: XA
authors.lastname: Zhang
authors.affiliation: State Key Laboratory of Pathogen and Biosecurity,Beijing Institute of Microbiology and Epidemiology,Beijing,P.R. China.
authors.forename: W
authors.initials: W
authors.lastname: Liu
authors.affiliation: State Key Laboratory of Pathogen and Biosecurity,Beijing Institute of Microbiology and Epidemiology,Beijing,P.R. China.
authors.forename: W-C
authors.initials: WC
authors.lastname: Cao
mesh_terms: D000328:Adult; D000368:Aged; D058345:Asymptomatic Infections / Q000453:epidemiology / Q000401:mortality; D002044:Bunyaviridae Infections / Q000453:epidemiology* / Q000401:mortality / Q000821:virology; D002681:China / Q000453:epidemiology; D021821:Communicable Diseases, Emerging / Q000453:epidemiology* / Q000401:mortality / Q000821:virology; D005260:Female; D005334:Fever / Q000453:epidemiology* / Q000821:virology; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016856:Phlebovirus / Q000502:physiology*; D015995:Prevalence; D016036:Seroepidemiologic Studies; D012959:Socioeconomic Factors; D013921:Thrombocytopenia / Q000453:epidemiology* / Q000401:mortality / Q000821:virology
keywords: Bunyavirus; China; meta-analysis; severe fever with thrombocytopenia syndrome