ABSTRACT
Conclusion:
Although it is thought that the COVID-19 pandemic will end in the following months owing to vaccine applications, it can be predicted that sporadic cases will still occur for a long time. Therefore, clinicians should take CCHF into consideration in their differential diagnosis. Also, it should be remembered that co-infections can be observed in endemic areas.
Results:
Of the 12 cases, 10 (83.3%) were men and 2 (16.7%) were women. The median (interquartile range) age was 51 (27-64) years. Eleven (91.7%) patients lived in rural regions, and seven (58.3%) had a history of tick contact. Five patients were hospitalized in an external center with a preliminary diagnosis of COVID-19 and transferred to our center due to clinical and laboratory deterioration. Loss of appetite, headache, fever, weakness, and muscle-joint pain were the most common complaints of the patients. Following the suspicion of COVID-19, thoracic computed tomography (CT) was performed in six patients, five of whom were transferred to an external center. None of the patients had any pathological findings following thoracic CT.
Methods:
This study comprised 12 patients over the age of 18 who were admitted to our clinic after the onset of the COVID-19 pandemic on March 11, 2020 and whose CCHF diagnosis was confirmed by reverse transcription-polymerase chain reaction with viral-RNA or enzyme-linked immunosorbent assay with immunoglobulin M antibodies. Epidemiological, clinical, and laboratory findings as well as treatment and prognosis of the patients were investigated.
Objective:
Crimean-Congo Hemorrhagic Fever (CCHF) is a disease of the viral hemorrhagic fever group and is endemic in certain regions in Turkey. Here, the demographic, clinical, and laboratory findings of patients diagnosed with CCHF during the Coronavirus disease-2019 (COVID-19) pandemic were examined, and differential diagnosis was stressed.
Keywords:
Crimean-Congo Hemorrhagic Fever, COVID-19 pandemic, lymphopenia, tick
References
1Ergonul O, Battal I. Potential sexual transmission of Crimean-Congo hemorrhagic fever infection. Jpn J Infect Dis 2014; 67: 137-8.
2Available from: https://hsgm.saglik.gov.tr/tr/zoonotikvektorel-kkka/detay.html
3Öngürü P, Bodur H. Kırım kongo kanamalı ateşi. J. Exp. Clin. Med 2012; 29: S175-81.
4Leblebicioglu H, Ozaras R, Irmak H, Sencan I. Crimean-Congo hemorrhagic fever in Turkey: Current status and future challenges. Antiviral Res 2016; 126: 21-34.
5Yagci-Caglayik D, Korukluoglu G, Uyar Y. Seroprevalence and risk factors of Crimean-Congo hemorrhagic fever in selected seven provinces in Turkey. J Med Virol 2014; 86: 306-14.
6Sağmak Tartar A, Balın ŞÖ, Akbulut A, Demirdağ K. Crimean Congo Hemorrhagic Fever in Eastern Turkey: Epidemiological and Clinical Evaluation. Turkiye Parazitol Derg 2019; 43: 26-9.
7Barkay O, Binay UD, Gül Ö, Karakeçili F. A significant increase at the number of Crimean-Congo haemorrhagic fever cases in COVID-19 pandemic: What is happening?. Klimik Derg 2020; 33: 197-8.
8Ergönül O. Crimean-Congo haemorrhagic fever. Lancet Infect Dis 2006; 6: 203-14.
9Wang D, Li R, Wang J, Jiang Q, Gao C, Yang J, et al. Correlation analysis between disease severity and clinical and biochemical characteristics of 143 cases of COVID-19 in Wuhan, China: a descriptive study. BMC Infect Dis 2020; 20: 519.
10Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management patients.html.
11Kayadibi H, Yapar D, Akdogan O, Ulusu NN, Baykam N. Hitit Index to distinguish patients with and without Crimean-Congo hemorrhagic fever. Ticks Tick Borne Dis 2019; 10: 1035-40.
12Bakir M, Ugurlu M, Dokuzoguz B, Bodur H, Tasyaran MA, Vahaboglu H, And The Turkish Cchf Study Group. Crimean-Congo haemorrhagic fever outbreak in Middle Anatolia: a multicentre study of clinical features and outcome measures. J Med Microbiol 2005; 54: 385-9.
13Cevik MA, Erbay A, Bodur H, Gülderen E, Baştuğ A, Kubar A, et al. Clinical and laboratory features of Crimean-Congo hemorrhagic fever: predictors of fatality. Int J Infect Dis 2008; 12: 374-9.
14Hewitt MG, Miller WT Jr, Reilly TJ, Simpson S. The relative frequencies of causes of widespread ground-glass opacity: a retrospective cohort. Eur J Radiol 2014; 83: 1970-6.
15Dülger AC, Yakarişik M, Uzun YE, Şahin AM. Treatment of Crimean-Congo Haemorrhagic Fever by Favipiravir in a Patient with Novel Coronavirus Co-Infection. Eur J Case Rep Intern Med 2020; 7: 002042.
16Büyüktuna SA, Hasbek M, Öksüz C, Baysal C, Öz M, Elaldı N, et al. Kırım Kongo Kanamalı Ateşi Hastasında COVID-19 Ko-enfeksiyonu: Bir Olgu Sunumu [COVID-19 Co-infection in a patient with Crimean Congo Hemorrhagic Fever: A Case Report]. Mikrobiyol Bul 2021; 55: 445-51.
17Pazarlı AC, Parlak Z, Ekiz T. COVID-19 and Crimean-Congo Hemorrhagic Fever: Similarities and Differences. Heart Lung 2020; 49: 892-3.