Analysis of clinical features and prognosis of hemorrhagic feverwith renal syndrome

Objective To investigate the clinical features and prognostic factors of hemorrhagic fever with renal syndrome (HFRS). Methods total of 131 patients with HFRS were divided into a blood purification group (n=51) and a non-blood purification group (n=80). The epidemiological data, clinical manifestations, laboratory examination, complications and outcome of HFRS were analyzed retrospectively, and the factors influencing the prognosis of HFRS patients were discussed. Results Most of the HFRS patients were young and middle-aged male farmers, and HFRS mostly occurred in autumn and winter. Most patients had no typical five-stage evolution process, and the typical symptoms of "three pains" (pain in the head, orbit, and lower back) and "three redness" (flushing of the face, neck and chest) were less common. The major clinical manifestations were fever, nausea and vomiting, poor appetite, proteinuria, congestion and edema of the bulbar conjunctiva, etc. The major laboratory findings were leukocytosis, thrombocytopenia, increased serum urea (UREA) and serum creatinine (CREA), increased alanine aminotransferase (ALT) and aspartate aminotransferase (AST), etc. Multivariate Logistic regression analysis revealed that AST (OR 0.992, 95% CI 0.984-1.000, P=0.038) and complications of central nervous system (OR 0.146, 95% CI 0.029-0.733, P=0.019) were independent risk factors for the prognosis of HFRS. Conclusions The clinical manifestations of HFRS are complex and diverse, with fewer typical cases, often accompanied by multiple organs, multiple systems and other damages to varying degrees.