PMID- 37033957
OWN - NLM
STAT- MEDLINE
DCOM- 20230411
LR  - 20240422
IS  - 1664-3224 (Electronic)
IS  - 1664-3224 (Linking)
VI  - 14
DP  - 2023
TI  - Effect of intravenous immunoglobulin therapy on the prognosis of patients with 
      severe fever with thrombocytopenia syndrome and neurological complications.
PG  - 1118039
LID - 10.3389/fimmu.2023.1118039 [doi]
LID - 1118039
AB  - BACKGROUND: Intravenous immunoglobulin (IVIG) has been reported to exert a 
      beneficial effect on severe fever with thrombocytopenia syndrome (SFTS) patients 
      with neurological complications. However, in clinical practice, the standard 
      regime is unclear and there is a lack of evidence from large-scale studies. 
      METHODS: A single-center retrospective study was conducted to determine the 
      influence of IVIG dosage and duration on SFTS patients with neurological 
      complications. The primary outcome was 28-day mortality, and laboratory 
      parameters before and after IVIG treatment were measured. Survival curves were 
      generated using the Kaplan-Meier method and analyzed with the log-rank test 
      according to the median IVIG dosage and IVIG duration. Besides, multivariate Cox 
      regression analysis was performed to examine the association between the 
      independent factors and 28-day mortality in SFTS patients. RESULTS: Overall, 36 
      patients (58.06%) survived, while 26 (41.9%) patients died. The median age of the 
      included patients was 70 (55-75) years, and 46.8% (29/62) were male. A 
      significantly higher clinical presentation of dizziness and headache was observed 
      in the survival group. The IVIG duration in the survival group was longer than in 
      the death group (P <0.05). Additionally, the IVIG dosage was higher in the 
      survival group than in the death group, but there was not a statistically 
      significant difference between the two groups (P = 0.066). The mediating effect 
      of IVIG duration was verified through the relationship between IVIG dosage and 
      prognosis using the Sobel test. Univariate analysis revealed that IVIG dosage 
      (HR: 0.98; 95% CI: 0.97-1.00; P = 0.007) and IVIG duration (HR: 0.54; 95% CI: 
      0.41-0.72; P <0.001) were significantly associated with risk of death. The 
      multivariate analysis generated an adjusted HR value of 0.98 (95% CI: 0.96-1.00; 
      P = 0.012) for IVIG dosage and 0.26 (95% CI: 0.09-0.78; P = 0.016) for dizziness 
      and headache. CONCLUSION: Prolonged high-dose IVIG is beneficial to the 28-day 
      prognosis in SFTS patients with neurological complications.
CI  - Copyright (c) 2023 Liu, Tong, He, Zhai, Wu, Wang and Jiang.
FAU - Liu, Yun
AU  - Liu Y
AD  - Department of Emergency Medicine, Nanjing Drum Tower Hospital, The Affiliated 
      Hospital of Nanjing University Medical School, Nanjing, China.
FAU - Tong, Hanwen
AU  - Tong H
AD  - Department of Emergency Medicine, Nanjing Drum Tower Hospital, The Affiliated 
      Hospital of Nanjing University Medical School, Nanjing, China.
FAU - He, Fei
AU  - He F
AD  - Department of Emergency Medicine, Nanjing Drum Tower Hospital, The Affiliated 
      Hospital of Nanjing University Medical School, Nanjing, China.
FAU - Zhai, Yu
AU  - Zhai Y
AD  - Department of Emergency Medicine, Nanjing Drum Tower Hospital, The Affiliated 
      Hospital of Nanjing University Medical School, Nanjing, China.
FAU - Wu, Chao
AU  - Wu C
AD  - Department of Infectious Disease, Nanjing Drum Tower Hospital, The Affiliated 
      Hospital of Nanjing University Medical School, Nanjing, China.
FAU - Wang, Jun
AU  - Wang J
AD  - Department of Emergency Medicine, Nanjing Drum Tower Hospital, The Affiliated 
      Hospital of Nanjing University Medical School, Nanjing, China.
FAU - Jiang, Chenxiao
AU  - Jiang C
AD  - Department of Pharmacy, Nanjing Drum Tower Hospital, The Affiliated Hospital of 
      Nanjing University Medical School, Nanjing, China.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20230322
PL  - Switzerland
TA  - Front Immunol
JT  - Frontiers in immunology
JID - 101560960
RN  - 0 (Immunoglobulins, Intravenous)
SB  - IM
EIN - Front Immunol. 2024 Apr 05;15:1383797. PMID: 38646537
MH  - Humans
MH  - Male
MH  - Aged
MH  - Female
MH  - *Immunoglobulins, Intravenous/therapeutic use
MH  - *Severe Fever with Thrombocytopenia Syndrome
MH  - Retrospective Studies
MH  - Dizziness/drug therapy
MH  - Prognosis
MH  - Headache/drug therapy
PMC - PMC10073413
OTO - NOTNLM
OT  - dosage
OT  - duration
OT  - intravenous immunoglobulin
OT  - mortality
OT  - neurological complications
OT  - severe fever with thrombocytopenia syndrome
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2023/04/11 06:00
MHDA- 2023/04/11 06:42
PMCR- 2023/01/01
CRDT- 2023/04/10 04:00
PHST- 2022/12/08 00:00 [received]
PHST- 2023/03/08 00:00 [accepted]
PHST- 2023/04/11 06:42 [medline]
PHST- 2023/04/10 04:00 [entrez]
PHST- 2023/04/11 06:00 [pubmed]
PHST- 2023/01/01 00:00 [pmc-release]
AID - 10.3389/fimmu.2023.1118039 [doi]
PST - epublish
SO  - Front Immunol. 2023 Mar 22;14:1118039. doi: 10.3389/fimmu.2023.1118039. 
      eCollection 2023.