Crucial parameter of the outcome in Crimean Congo hemorrhagic fever: Viral load.

Abstract Background Crimean Congo hemorrhagic fever (CCHF) is a fatal disease with a mortality rate of 5–30%. CCHF can be asymptomatic or it may progress with bleeding and cause mortality. Objectives To evaluate relation of viral load with mortality, clinical and laboratory findings in CCHF. Study design A total of 126 CCHF patients were included. Serum samples obtained from all patients on admission for measurement of viral load. Results In our study, mortality rate was 11.1%. The most important prognostic factor was viral load. Mean viral load was 8.3 × 10 7  copy/ml and 4.6 × 10 9  copy/ml in survived and dead patients, respectively ( p 1130 U/l, ALT >490 U/l, CPK >505 U/l, LDH >980 U/l, platelet count 3 /l, creatinine >1.4 mg/dl, INR >1.3, d -dimer >7100 ng/dl, and viral load >1.03 × 10 8  copy/ml. Patients with 10 8  copy/ml or higher viral load had diarrhea, headache, unconsciousness, bleeding, and seizure significantly more frequently ( p  d -dimer levels, and INR were found to be significantly higher in these group. Conclusions There are several severity criteria for prognosis of CCHF. In addition to these parameters, we introduce creatinine as a predictive factor for prognosis. Our study, which has the largest number of patients among studies that evaluate viral load on CCHF shows that viral load is the most effective parameter on mortality.