Abstract
Crimean-Congo hemorrhagic fever is a life threatening illness. We aimed to detect the effect of the leukocyte counts on survival. This is the first study analyzing the relationship between mortality and leukocyte counts. A total of 220 patients were evaluated retrospectively. The mortality rate was found 16.4%. The analysis of relationship between leukocyte counts and mortality rates showed us some important clues for pathogenesis. ROC curve analysis revealed that if the leukocyte counts on admission were ≥ 2950/mm3, mortality rate could be predicted with 62.1% sensitivity. In consideration of the mean hospitalization length in fatal cases (4.3 days), third-admission day leukocyte counts were compared. Increase of the neutrophils and decrease of the lymphocytes and monocytes were found as significant risk factors for mortality (p = 0.01, p = 0.037, p = 0.001). The mortality risk was found 8-12 folds higher in patients with upper levels of cut- off for leukocytes (2950 µl), LDH (967 U/L) and aPTT (42.4 s), ALT (>119.5 u /l) which were determined as an independent predictors of mortality. The depletion of monocytes, lymphocytes and the increase of neutrophil counts were correlated with poor outcome. These results suggest the importance of mononuclear immune response for survival in CCHF.
