Does electrocardiography at admission predict outcome in Crimean-Congo hemorrhagic fever?

Abstract

Background & objectives: Crimean-Congo hemorrhagic fever is an acute viral hemorrhagic fever with considerable mortality. Despite increasing knowledge about hemorrhagic fever viruses, the pathogenesis of Crimean-Congo hemorrhagic fever and causes of death were not well described. We aimed to evaluate whether there were electrocardiographic parameters designating mortality among these patients. Study design: This retrospective study was performed among confirmed Crimean-Congo hemorrhagic fever cases in Turkey. Electrocardiography was available in 49 patients within 24 h of hospitalization. All electrocardiograms were evaluated by two expert cardiologists according to Minnesota coding system. Results: Among patients with available electrocardiograms, there were 31 patients who survived, and 18 patients who died of Crimean-Congo hemorrhagic fever. Both groups were similar in terms of age, sex, body temperature, heart rate, and blood parameters. T-wave changes and bundle branch block were more frequently encountered among those who died. Presence of T-wave negativity or bundle branch block in this cohort of patients with Crimean-Congo hemorrhagic fever predicted death with a sensitivity of 72.7%, specificity of 92.6%, positive predictive value of 88.9%, negative predictive value of 80.6%. Conclusions: We think within the light of our findings that simple electrocardiography at admission may help risk stratification among Crimean-Congo hemorrhagic fever cases.