Risk Factors Associated With Poor Prognosis in Children With Crimean-Congo Hemorrhagic Fever

CrimeanCongo hemorrhagic fever (CCHF) was a rare disease in Iran before 1999. During the last 15 years, it has been reported from different provinces of Iran, mostly from southeastern Iran. This study aimed to evaluate the factors associated with poor outcome in children and adolescents with CCHF. We studied all files of children (age lt 19 years old) with CCHF who were admitted to our hospital in Zahedan from September 1999 to October 2012. Evaluated Factors in association with the prognosis included aspartate transaminase (AST), alanine transaminase (ALT), activated partial thromboplastin time (aPTT), prothrombin time (PT), platelet count, and hemorrhagic diathesis. We evaluated 39 children and adolescents (mean age, 12.9 ± 4.2 years) with CCHF. Among them, nine patients (23%) died. The risk factors associated with poor prognosis were platelet count lt 50000, PT gt 15 seconds, aPTT gt 45 seconds, the presence of hemorrhagic diathesis, ALT and AST more than fivetime the upper limit of normal, loss of consciousness, and myocarditis. The most important factor associated with mortality was a platelet count lt 50000 at the admission time. More investigations on the efficacy of drugs such as steroid and specific immunoglobulin in treatment of patients with risk factors such as severe thrombocytopenia are needed.