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ORIGINAL RESEARCH article

Front. Immunol.
Sec. Vaccines and Molecular Therapeutics
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1471511
This article is part of the Research Topic Understanding Immunity Against Tick- and Mosquito-Borne Viruses to Develop Effective Vaccines and Therapeutics View all 4 articles

Aspartate Aminotransferase to Platelet Ratio Correlates with Poor Prognosis and Metabolic Alterations in Dabie Bandavirus Infection

Provisionally accepted
Chunxia Guo Chunxia Guo 1Ruixue Li Ruixue Li 2Xia Wang Xia Wang 3*Xiulan Peng Xiulan Peng 3
  • 1 Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
  • 2 Wuhan University hospital, Wuhan, China
  • 3 Jianghan University, Wuhan, China

The final, formatted version of the article will be published soon.

    Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease with a high mortality rate caused by Dabie bandavirus. The aspartate aminotransferase to platelet ratio index (APRI) is a biomarker of liver injury and inflammation. This study aimed to examine the correlation between APRI and SFTS prognosis using clinical data analysis and attempt to explain its prognostic significance through metabolic analysis. Methods: Data from hospitalized patients with a confirmed diagnosis of SFTS virus infection at Wuhan Union Hospital were retrospectively collected. The low and high APRI groups were 1:1 matched using propensity score matching (PSM) analysis. Fresh plasma was collected from patients with SFTS on admission and used for metabolic tests. Results: A total of 617 patients with SFTS who met the inclusion criteria were selected for analysis. Survival analysis revealed that patients with SFTS with high APRI (> 35.3) had a substantially higher death rate than those with low APRI (≤ 35.3). Receiver operating characteristic analysis showed the predictive performance of APRI for SFTS prognosis is 0.77, with a 95% CI of 0.73-0.80, which was superior to NLR (area under the curve (AUC): 0.65), platelet-tolymphocyte ratio (AUC: 0.54), and systemic immune-inflammation index (AUC: 0.58). The prognostic value and predictive performance of APRI were more substantial after PSM than before PSM. Metabolomic testing identified several differential serum metabolites, with alanine, aspartate, glutamate, glycerophospholipid, and tryptophan metabolism being the most important metabolic pathways. Conclusion: A high APRI score was associated with relatively higher mortality in patients with SFTS, and its predictive performance for the survival outcome of SFTS was superior to that of well-recognized inflammatory scores. Alanine, aspartate, and glutamate metabolism are involved in the progression of SFTS.

    Keywords: Severe fever with thrombocytopenia syndrome, Aspartate aminotransferase to platelet ratio index, Metabolic analysis, prognostic biomarker, Dabie bandavirus

    Received: 27 Jul 2024; Accepted: 18 Dec 2024.

    Copyright: © 2024 Guo, Li, Wang and Peng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Xia Wang, Jianghan University, Wuhan, China

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