The Association of De Ritis Ratio with the Severity of Crimean-Congo Hemorrhagic Fever

Aim: This study aimed to present the characteristics and poor prognostic factors of Crimean-Congo hemorrhagic fever (CCHF) patients. Materials & methods: Adult patients (>18 years) with CCHF were included in this retrospective study. Demographics, risk scores and laboratory findings of survivors and nonsurvivors were compared. Results: Fifteen (9.2%) of 163 CCHF patients were nonsurvivors and had a higher Severity Score Index (p < 0.001), Severity Grade Score (p < 0.001) and De Ritis ratio (aspartate transaminase/alanine transaminase) (p < 0.001). De Ritis ratio was >3 in 10.1% of survivors and 53.3% of nonsurvivors (p < 0.001). In multivariate analysis, De Ritis ratio >3 (OR: 5.428, p = 0.045) and SGS (OR: 1.776, p = 0.005) were found as predictive factors. Conclusion: De Ritis ratio may predict prognosis in combination with severity risk scores in CCHF. Plain language summaryCrimean-Congo hemorrhagic fever is a disease caused by a virus that causes a high fever and bleeding. Unfortunately, there is no cure for this disease yet. It is important for doctors to be able to predict which patients are more or less likely to get better, so they need inexpensive tests to predict this. One example test checks the liver enzymes in the blood. This study looked at these tests and discovered that when a certain enzyme called aspartate transaminase is high, patients were more likely to be seriously ill and the sickness affected their whole body. Another enzyme called alanine transaminase was also high when sickness was severe. By checking liver enzymes, doctors can predict whether a patient will recover. If the ratio of these two enzymes, called the De Ritis ratio, is more than 3, the patient may not recover easily. Tweetable abstractDe Ritis ratio (aspartate transaminase/alanine transaminase) increases in correlation with clinical severity in patients with Crimean-Congo hemorrhagic fever. If the De Ritis ratio is >3, the probability of mortality is found to increase 5.4-times.