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Volume 25, Number 2—February 2019
Dispatch

Crimean-Congo Hemorrhagic Fever, Kosovo, 2013–2016

Salih Ahmeti1, Lindita Berisha1, Bahrije Halili, Florim Ahmeti, Ronald von Possel, Corinna Thomé-Bolduan, Anett Michel, Simone Priesnitz, Emil C. Reisinger, Stephan Günther, Andreas Krüger, Kurtesh Sherifi, Xhevat Jakupi, Christoph J. HemmerComments to Author , and Petra Emmerich
Author affiliations: University Hasan Prishtina, Prishtina, Kosovo (S. Ahmeti); University Clinical Center of Kosovo, Prishtina (L. Berisha, B. Halili); National Institute of Public Health of Kosovo, Prishtina (F. Ahmeti, X. Jakupi); Bernhard Nocht Institute of Tropical Medicine, Hamburg, Germany (R. von Possel, C. Thomé-Bolduan, S. Günther,; P. Emmerich); Bundeswehr Hospital, Hamburg (A. Michel, S. Priesnitz, A. Krüger); University of Rostock, Rostock, Germany (E.C. Reisinger, C.J. Hemmer, P. Emmerich); University Hasan Prishtina Faculty of Agriculture and Veterinary Science, Prishtina (K. Sherifi)

Main Article

Table 2

Clinical and laboratory findings and their association with death in patients with Crimean-Congo hemorrhagic fever, Kosovo, 2013–2016*

Finding OR for death if present (95% CI) p value
Clinical findings significantly associated with death
Coma 35.0 (3.32–369) 0.003
Somnolence 27.0 (3.80–192) 0.001
Fasciculations† NA (25.2 [2.45–259]) NA (0.007)
Hemoperitoneum 16.6 (2.47–112) 0.004
Hematemesis 11.4 (1.74–74.7) 0.011
Bleeding gums 11.3 (2.04–63.1) 0.006
Ecchymoses 7.31 (1.25–42.8) 0.027
Melena 7.20 (1.31–39.6) 0.023
Petechiae 6.67 (1.31–34.0) 0.023
>4 of the 5 previous findings 24.0 (2.33–247) 0.008
Diarrhea 7.20 (1.31–39.6) 0.023
Jaundice†
 NA (7.87 [0.71–87.3])
 NA (0.093)
Clinical findings not significantly associated with death
Vertigo 5.00 (0.53–47.3) 0.160
Female sex 3.56 (0.50–25.6) 0.206
Epistaxis 2.08 (0.46–9.51) 0.343
Sweats 2.00 (0.11–35.4) 0.636
Joint pain 1.92 (0.43–8.61) 0.391
Headache 1.31 (0.29–5.89) 0.723
Conjunctivitis 1.31 (0.29–5.89) 0.723
Abdominal pain 1.20 (0.23–6.34) 0.830
Tiredness 1.05 (0.08–13.1) 0.968
Bradycardia 1.05 (0.08–13.1) 0.968
Metrorrhagia 0.95 (0.08–11.1) 0.968
Hypotension 0.87 (0.19–4.03) 0.864
Muscular pain 0.75 (0.11–5.32) 0.774
Vomiting 0.52 (0.12–2.32) 0.391
Hyperemia 0.42 (0.09–1.86) 0.251
Anorexia 0.28 (0.04–2.01) 0.206
Nausea 0.25 (0.03–2.40) 0.230
Hiccup† NA (4.67 [0.37–58.3]) NA (0.232)
Hypertension† NA (2.10 [0.12–37.1]) NA (0.613)
Ribavirin not given
 1.059 (0.162–6.94)
 0.952
Laboratory findings significantly associated with death
VL >1 × 108.5 80.0 (6.3–1,011) 0.001
LDH >3,500 U/L† NA (26.7 [2.24–317]) NA (0.009)
LDH >2,700 U/L 37.5 (2.77–507) 0.006
Leukocytes >7.7 15.8 (1.53–164) 0.020
Leukocytes >8.0† NA (16.7 [1.62–172]) NA (0.018)
Platelets <50.000/µL
 5.25 (1.07–25.8)
 0.041
Laboratory findings not significantly associated with death
ALT >168 U/L 3.20 (0.48–21.2) 0.228
AST >147 U/L 2.75 (0.52–14.4) 0.232
CK >1,037 1.95 (0.44–8.55) 0.376
IgG <2.5‡ NA (4.67 [0.45–48.3]) NA (0.196)
IgM <2.5‡ NA (4.67 [0.45–48.3]) NA (0.196)

*ALT, alanine aminotransferase; AST, aspartate aminotransferase; CK, creatine kinase; LDH, lactate dehydrogenase; NA, not applicable; OR, odds ratio; VL, viral load.
†The OR could not be determined because there were no survivors with this symptom. The value in parentheses would have been obtained if 1 hypothetical survivor had this symptom or test result.
‡The OR could not be determined because there were no deaths among patients with this finding. The value in parentheses would have been obtained if 1 hypothetical fatal case had this test result.

Main Article

1These first authors contributed equally to this article.

Page created: January 18, 2019
Page updated: January 18, 2019
Page reviewed: January 18, 2019
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