Bioclinical Test to Predict Nephropathia Epidemica Severity at Hospital Admission

Maxime Hentzien (1, 2) , Stéphanie Mestrallet (3, 2) , Pascale Halin (3) , Laure-Anne Pannet (3) , Delphine Lebrun (3) , Moustapha Dramé (1) , Firouzé Bani-Sadr (2) , Jean-Marc Galempoix (3) , Christophe Strady , Jean-Marc Reynes (4) , Christian Penalba (3) , Amelie Servettaz (2)

1 CHU Reims - Centre Hospitalier Universitaire de Reims
2 Hôpital universitaire Robert Debré [Reims]
3 Centre Hospitalier de Charleville-Mezières
4 CNR-UBIVE - Centre National de Référence des Hantavirus - Biologie des Infections Virales Emergentes

We conducted a multicenter, retrospective cohort study of hospitalized patients with serologically proven nephropathia epidemica (NE) living in Ardennes Department, France, during 2000-2014 to develop a bioclinical test predictive of severe disease. Among 205 patients, 45 (22.0%) had severe NE. We found the following factors predictive of severe NE: nephrotoxic drug exposure (p = 0.005, point value 10); visual disorders (p = 0.02, point value 8); microscopic or macroscopic hematuria (p = 0.04, point value 7); leukocyte count >10 × 109 cells/L (p = 0.01, point value 9); and thrombocytopenia <90 × 109/L (p = 0.003, point value 11). When point values for each factor were summed, we found a score of <10 identified low-risk patients (3.3% had severe disease), and a score >20 identified high-risk patients (45.3% had severe disease). If validated in future studies, this test could be used to stratify patients by severity in research studies and in clinical practice.

Keywords: hemorrhagic disease; hospital admission; Europe; leukocytosis; France; nephropathia epidemica; Puumala virus; nephrotoxic drug exposure; acute kidney injury; prognosis; cohort studies; risk factors; disease severity; thrombocytopenia; hantavirus; viruses; hematuria; visual disorder

Domains: Life Sciences [q-bio]; Life Sciences [q-bio]; Human health and pathology; Life Sciences [q-bio]; Human health and pathology; Infectious diseases

Maxime Hentzien, Stéphanie Mestrallet, Pascale Halin, Laure-Anne Pannet, Delphine Lebrun, et al.. Bioclinical Test to Predict Nephropathia Epidemica Severity at Hospital Admission. Emerging Infectious Diseases, 2018, 24 (6), pp.1045 - 1054. ⟨10.3201/eid2406.172160⟩. ⟨pasteur-01834306⟩