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Associations between Chest CT Abnormalities and Clinical Features in Patients with the Severe Fever with Thrombocytopenia Syndrome
Authors:Hiroki Ashizawa  Kazuko Yamamoto  Nobuyuki Ashizawa  Kazuaki Takeda  Naoki Iwanaga  Takahiro Takazono  Noriho Sakamoto  Makoto Sumiyoshi  Shotaro Ide  Asuka Umemura  Masataka Yoshida  Yuichi Fukuda  Tsutomu Kobayashi  Masato Tashiro  Takeshi Tanaka  Shungo Katoh  Konosuke Morimoto  Koya Ariyoshi  Shimpei Morimoto  Mya Myat Ngwe Tun  Shingo Inoue  Kouichi Morita  Shintaro Kurihara  Koichi Izumikawa  Katzunori Yanagihara  Hiroshi Mukae
Abstract:Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by the SFTS virus. It involves multiple organ systems, including the lungs. However, the significance of the lung involvement in SFTS remains unclear. In the present study, we aimed to investigate the relationship between the clinical findings and abnormalities noted in the chest computed tomography (CT) of patients with SFTS. The medical records of 22 confirmed SFTS patients hospitalized in five hospitals in Nagasaki, Japan, between April 2013 and September 2019, were reviewed retrospectively. Interstitial septal thickening and ground-glass opacity (GGO) were the most common findings in 15 (68.1%) and 12 (54.5%) patients, respectively, and lung GGOs were associated with fatalities. The SFTS patients with a GGO pattern were elderly, had a disturbance of the conscious and tachycardia, and had higher c-reactive protein levels at admission (p = 0.009, 0.006, 0.002, and 0.038, respectively). These results suggested that the GGO pattern in patients with SFTS displayed disseminated inflammation in multiple organs and that cardiac stress was linked to higher mortality. Chest CT evaluations may be useful for hospitalized patients with SFTS to predict their severity and as early triage for the need of intensive care.
Keywords:severe fever with thrombocytopenia syndrome   lung abnormalities   chest computed tomography   ground-glass opacity
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