Mem Inst Oswaldo Cruz, Rio de Janeiro, FAST TRACK
Original Article

Lipase and factor V (but not viral load) are prognostic factors for the evolution of severe yellow fever cases

Luciana Vilas Boas Casadio, Ana Paula Moreira Salles, Fernanda de Mello Malta, Gabriel Fialkovitz Leite, Yeh-Li Ho, Michele Soares Gomes-Gouvêa, Luiz Marcelo Sá Malbouisson, Anna Sara Shafferman Levin, Raymundo Soares de Azevedo Neto, Flair José Carrilho, Ana Catharina Seixas Santos Nastri, João Renato Rebello Pinho

Universidade de São Paulo, São Paulo SP, Brasil

DOI: 10.1590/0074-02760190033
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ABSTRACT

Severe YF cases (n=62) were admitted to ICU and submitted to the routine laboratorial assays on admission. YFVRNA was detected in serum and urine by RT- qPCR and then sequenced. Patients were classified in two groups (“survival” or “death”) after YF diagnosis. Univariate analysis showed the following variables associated with outcome: ALT, AST, AST/ALT, Total bilirubin, CKD-EPI, Ammonia, Lipase, Factor V, INR, Lactate and Bicarbonate. Logistic regression model showed two independent variables associated with death (lipase: OR 1.018, 95% CI 1.007 to 1.030, p=0.002) and factor V (OR -0.955, 95% CI 0.929 to 0.982, p=0.001). The estimated lipase and factor V cut-off values that maximizes sensitivity and specificity for death prediction are 147.5 U/L (AUC = 0.879) and 56.5% (AUC = 0.913). The finding of Factor V and Lipase as independent variables associated with death reinforces the importance of hemorrhagic events and pancreatitis for the evolution of the severe YF cases.

LVBC and APMS contributed equally to this article.
Corresponding author: luciana.vilasboas@gmail.com

 http://orcid.org/0000-0001-8341-8960

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