The role of selenium in severe fever with thrombocytopenia syndrome: an integrative analysis of surveillance data and clinical data.

Tian-Le Che, Xin-Lou Li, Jian-Bo Tian, Gang Wang, Xue-Fang Peng, Hai-Yang Zhang, Jia-Hao Chen, Ying Zhu, Wen-Hui Zhang, Tao Wang, Bao-Cheng Liu, Qiang Xu, Chen-Long Lv, Bao-Gui Jiang, Zhong-Jie Li, Li-Qun Fang, Wei Liu

Journal: International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases 2022;122():38-45

PMID: 35605950

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Abstract

OBJECTIVES

Selenium deficiency can be associated with increased susceptibility to some viral infections and even more severe diseases. In this study, we aimed to examine whether this association applies to severe fever with thrombocytopenia syndrome (SFTS).

METHOD

An observational study was conducted based on the data of 13,305 human SFTS cases reported in mainland China from 2010 to 2020. The associations among incidence, case fatality rate of SFTS, and crop selenium concentration at the county level were explored. The selenium level in a cohort of patients with SFTS was tested, and its relationship with clinical outcomes was evaluated.

RESULTS

The association between selenium-deficient crops and the incidence rate of SFTS was confirmed by multivariate Poisson analysis, with an estimated incidence rate ratio (IRR, 95% confidence interval [CI]) of 4.549 (4.215-4.916) for moderate selenium-deficient counties and 16.002 (14.706-17.431) for severe selenium-deficient counties. In addition, a higher mortality rate was also observed in severe selenium-deficient counties with an IRR of 1.409 (95% CI: 1.061-1.909). A clinical study on 120 patients with SFTS showed an association between serum selenium deficiency and severe SFTS (odds ratio, OR: 2.94; 95% CI: 1.00-8.67) or fatal SFTS (OR: 7.55; 95% CI: 1.14-50.16).

CONCLUSION

Selenium deficiency is associated with increased susceptibility to SFTS and poor clinical outcomes.

Address: State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China.; Department of Medical Research, Key Laboratory of Environmental Sense Organ Stress and Health of the Ministry of Environmental Protection, PLA Strategic Support Force Medical Center, Beijing, P. R. China.; Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, 430000, China.; Center for Disease Control and Prevention of Central Theater Command, Beijing, P. R. China.; Health Supervision Institute of Dongcheng District, Beijing, P. R. China.; Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, P. R. China. Electronic address: [email protected].; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China. Electronic address: [email protected].; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China; Beijing Key Laboratory of Vector Borne and Natural Focus Infectious Diseases, Beijing 100071, P. R. China; Graduate School of Anhui Medical University, Hefei 230601, P.R. China. Electronic address: [email protected].

DOI: 10.1016/j.ijid.2022.05.042

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MeSH Terms: Bunyaviridae Infections, China, Fever, Humans, Phlebovirus, Selenium, Severe Fever with Thrombocytopenia Syndrome, Thrombocytopenia