ArticleMemorias do Instituto Oswaldo Cruz2019
Lipase and factor V (but not viral load) are prognostic factors for the evolution of severe yellow fever cases.
Article in Memorias do Instituto Oswaldo Cruz, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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16 citing papers in PubMed, 27 citations in OpenAlex.
- Mesenteric Ischemia and Bacterial Translocation Precipitate the Intoxication Phase of Yellow Fever.The Journal of infectious diseases · 2026Article
- Technical validation and implementation of a multiplex real-time PCR for differential diagnostic detection of Zika virus, yellow fever virus, dengue virus and chikungunya virus (ZYDC-PCR).BMC infectious diseases · 2026Article
- Pulmonary Complications in Fatal Yellow Fever, Brazil, 2017-2019.Emerging infectious diseases · 2026Article
- Article
- Prophylactic and therapeutic neutralizing monoclonal antibody treatment prevents lethal yellow fever infection.JCI insight · 2025Article
- Perspective of Quilombola Communities in Brazil on a Yellow Fever Outbreak and Vaccination.The American journal of tropical medicine and hygiene · 2025Article
- Intensive Therapeutic Plasma Exchange-New Approach to Treat and Rescue Patients with Severe Form of Yellow Fever.Tropical medicine and infectious disease · 2025Article
- Accuracy of yellow fever case definition of epidemiologic surveillance, São Paulo, 2018.Revista de saude publica · 2023Article
- Evaluation of Whatman FTA cards for the preservation of yellow fever virus RNA for use in molecular diagnostics.PLoS neglected tropical diseases · 2022Article
- Risk Factors for Acute Kidney Injury and Death in Patients Infected With the Yellow Fever Virus During the 2018 Outbreak in São Paulo, Brazil.Kidney international reports · 2022Article
- Updating the Phylodynamics of Yellow Fever Virus 2016-2019 Brazilian Outbreak With New 2018 and 2019 São Paulo Genomes.Frontiers in microbiology · 2022Article
- Staging liver fibrosis after severe yellow fever with ultrasound elastography in Brazil: A six-month follow-up study.PLoS neglected tropical diseases · 2021Article
- Puerarin enhances intestinal function in piglets infected with porcine epidemic diarrhea virus.Scientific reports · 2021Article
- A Yellow Fever Virus 17D Infection and Disease Mouse Model Used to Evaluate a Chimeric Binjari-Yellow Fever Virus Vaccine.Vaccines · 2020Article
- Recent sylvatic yellow fever virus transmission in Brazil: the news from an old disease.Virology journal · 2020Review
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Authors and funding
12 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite a highly efficacious vaccine, yellow fever (YF) is still a major threat in developing countries and a cause of outbreaks. In 2018, the Brazilian state of São Paulo witnessed a new YF outbreak in areas where the virus has not been detected before.
objectiveThe aim is to describe the clinical and laboratorial characteristics of severe cases of YF, evaluate viral to determine markers associated with fatal outcome.
methodsAcute severe YF cases (n = 62) were admitted to the Intensive Care Unit of a reference hospital and submitted to routine laboratorial evaluation on admission. YFV-RNA was detected in serum and urine by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and then sequenced. Patients were classified in two groups: survival or death.
findingsIn the univariate analysis the following variables were associated with outcome: alanin aminotransferase (ALT), aspartat aminotransferase (AST), AST/ALT ratio, total bilirubin (TB), chronic kidney disease epidemiology collaboration (CKD-EPI), ammonia, lipase, factor V, international normalised ratio (INR), lactate and bicarbonate. Logistic regression model showed two independent variables associated with death: lipase [odds ratio (OR) 1.018, 95% confidence interval (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 maximised sensitivity and specificity for death prediction were 147.5 U/L [area under the curve (AUC) = 0.879], and 56.5% (AUC = 0.913). MAIN
conclusionsYF acute severe cases show a generalised involvement of different organs (liver, spleen, heart, kidneys, intestines and pancreas), and different parameters were related to outcome. Factor V and lipase are independent variables associated with death, reinforcing the importance of hemorrhagic events due to fulminant liver failure and pointing to pancreatitis as a relevant event in the outcome of the disease.
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