Features of hematological changes in patients with hemorrhagic fever with renal syndrome depending on the severity and period of the disease

This article provides a comparative analysis of the features of hematological changes in patients with hemorrhagic fever with renal syndrome (HFRS) in the Samara region, depending on the severity and period of the disease. In-depth study of the metabolic profile was carried out in patients with early hospitalization (until the 5^th day of illness). Enzyme studies (ALT, AST, LDH, CPK), indicators of the protein spectrum and electrolytes were performed in patients (n = 73) who were admitted in the initial period of the disease. The patients with proven cases of HFRS were divided into 3 comparison groups: group 1 (n = 22) represents cases of a mild form of the disease (urea level up to 8.3 mmol / l, creatinine up to 130 mmol / l); group 2 (n = 25) includes the cases of a moderate form of the disease (urea level up to 19 mmol / l, creatinine up to 300 μmol / l,); group 3 (n = 26) comprises cases of a severe form of the disease (urea level above 19 mmol / l, creatinine above 300 μmol / l). The comparison of the groups was performed by using single-factor analysis of variance, between-group comparisons was carried out by means of Dunnetts test. Spearman’s correlation analysis was performed to investigate the relationships. Our study demostrates that thrombocytopenia and lymphopenia, as well as a significant increase in ferritin and C-reactive protein (10–20-fold) are the early signs of any severity of the disease. Both the level of urea and creatinine and their concentration in the blood as well as aggravated trombo- and lymphocytopenia, determine the severity of the disease. The revealed differences in the key metabolic indicators on the 3^rd–5^th day of the disease will allow to solve the problem of early prediction of the severity of the disease, which will be fully manifested in the oliguric period.