Resting Heart Rate in Children with Crimean–Congo Hemorrhagic Fever: A Tool to Identify Patients at Risk?
- 1 January 2014
- journal article
- Published by Mary Ann Liebert Inc in Vector-Borne and Zoonotic Diseases
- Vol. 14 (1), 59-65
- https://doi.org/10.1089/vbz.2013.1384
Abstract
We aimed to assess the association between resting heart rate (RHR) and severe infection in children with Crimean-Congo hemorrhagic fever (CCHF). In all, 121 patients under 18 years of age with a laboratory-confirmed diagnosis of CCHF were enrolled in the study. Patients were classified into two groups based on disease severity (severe group and nonsevere group). RHR was measured by electrocardiography (ECG) on admission. Maximum P-wave duration (Pmax), P-wave dispersion (Pd), QRS duration, corrected QT interval, and QT dispersion were also measured. Mean age was 11.4±3.9 years and 84 patients were male. Twenty-six patients were classified as severe. Patients in this group had a higher RHR (103.6±10.4 vs. 80.5±8.1, p=0.001) than those with nonsevere disease. There was no difference in Pmax, Pd, QRS duration, QTcmax, or QTc dispersion. The optimal cutoff value of RHR to predict disease severity was>96 beats per minute (bpm), with 70.6% sensitivity and 50.1% specificity. Bleeding, thrombocytopenia (≤80×10(9)/L), elevated aspartate transaminase (AST) (>208 IU/L), elevated alanine transaminase (ALT) (>87 IU/L), elevated lactate dehydrogenase (LDH) (>566 IU/L), long activated partial thromboplastin time (aPTT) (>42 s), and increased hospitalization days were more frequent in patients with RHR >96 bpm. Multivariate logistic regression analysis revealed low platelet count (42 s), high LDH (>566 IU/L), and elevated RHR (>96 bpm) as independent risk factors for severe disease. We conclude that elevated RHR was significantly associated with severe disease in children with CCHF, thus offering the potential to identify patients with increased risk.Keywords
This publication has 25 references indexed in Scilit:
- Oxidative Stress and Central Cardiovascular Regulation - Pathogenesis of Hypertension and Therapeutic Aspects -Circulation Journal, 2010
- Resting heart rate and cardiovascular events: time for a new crusade?European Heart Journal, 2009
- Relation of Heart Rate at Rest and Long-Term (>20 Years) Death Rate in Initially Healthy Middle-Aged MenThe American Journal of Cardiology, 2009
- Hantavirus Infection Induces a Typical Myocarditis That May Be Responsible for Myocardial Depression and Shock in Hantavirus Pulmonary SyndromeThe Journal of Infectious Diseases, 2007
- Analysis of risk-factors among patients with Crimean-Congo haemorrhagic fever virus infection: severity criteria revisitedClinical Microbiology & Infection, 2006
- Crimean–Congo hemorrhagic fever in Eastern Turkey: clinical features, risk factors and efficacy of ribavirin therapyJournal of Infection, 2006
- Crimean–Congo hemorrhagic feverAntiviral Research, 2004
- Characteristics of Patients with Crimean-Congo Hemorrhagic Fever in a Recent Outbreak in Turkey and Impact of Oral Ribavirin TherapyClinical Infectious Diseases, 2004
- The Clinical Pathology of Crimean-Congo Hemorrhagic FeverClinical Infectious Diseases, 1989