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Risk of venous thromboembolism following hemorrhagic fever with renal syndrome: a self-controlled case series study
Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Infectious Diseases.
Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Infectious Diseases.
2018 (English)In: Clinical Infectious Diseases, ISSN 1058-4838, E-ISSN 1537-6591, Vol. 66, no 2, p. 268-273Article in journal (Refereed) Published
Abstract [en]

Background: Bleeding is associated with viral hemorrhagic fevers; however, thromboembolic complications have received less attention. Hemorrhagic fever with renal syndrome (HFRS) is a mild viral hemorrhagic fever caused by Puumala hantavirus. We previously identified HFRS as a risk factor for myocardial infarction and stroke, but the risk for venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is unknown.

Methods: Personal identity numbers from the Swedish HFRS database were cross-linked with the National Patient register to obtain information on all causes for hospitalization during 1964 to 2013. The self-controlled case series method was used to calculate the incidence rate ratio (IRR) for first VTE, DVT, and PE during 1998 to 2013.

Results: From 7244 HFRS patients, there were 146 with a first VTE of which 74 were DVT and 78 were PE, and 6 patients had both DVT and PE. The overall risk for a VTE was significantly higher during the first 2 weeks following HFRS onset, with an IRR of 64.3 (95% confidence interval [CI], 36.3-114). The corresponding risk for a DVT was 45.9 (95% CI, 18-117.1) and for PE, 76.8 (95% CI, 37.1-159). Sex interacted significantly with the association between HFRS and VTE, with females having a higher risk compared with males.

Conclusions: A significantly increased risk for VTE was found in the time period following HFRS onset. It is important to keep this in mind and monitor HFRS patients, and possibly other viral hemorrhagic fever patients, for early symptoms of VTE.

Place, publisher, year, edition, pages
Oxford University Press, 2018. Vol. 66, no 2, p. 268-273
Keywords [en]
hemorrhagic fever with renal syndrome, venous thromboembolism, deep vein thrombosis, pulmonary embolism, viral haemorrhagic fever
National Category
Infectious Medicine
Identifiers
URN: urn:nbn:se:umu:diva-144392DOI: 10.1093/cid/cix777ISI: 000419658600020PubMedID: 29020303OAI: oai:DiVA.org:umu-144392DiVA, id: diva2:1182460
Available from: 2018-02-13 Created: 2018-02-13 Last updated: 2018-06-09Bibliographically approved

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Connolly-Andersen, Anne-MarieAhlm, Clas

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