Serkan Bolat, Seyit Ali Buyuktuna
International Journal of Medical Biochemistry - 2025;8(4):300-305
Objectives: Crimean-congo hemorrhagic fever (CCHF) is a viral disease characterized by thrombocytopenia and sys- temic inflammation. In this study, we evaluated the role of platelet-normalizing biomarkers as diagnostic and prognos- tic indicators of CCHF. Methods: This study included 60 patients with CCHF and 30 age-/sex-matched healthy controls. Biochemical param- eters, including aspartate aminotransferase, alanine aminotransferase (ALT), gamma-glutamyl transferase, alkaline phosphatase, C-reactive protein and interleukin-6 (IL-6) levels were measured using photometric or electrochemilumi- nescence methods (Roche Cobas 8000, c702 and e801). Coagulation parameters' levels; activated partial thromboplas- tin time, international normalized ratio, fibrinogen, and D-dimer were determined using Roche Cobas t511. These pa- rameters were expressed as ratios to platelet count (Plt). Comparisons were performed between the CCHF cohort and control group. Subgroup analyses evaluated associations with intensive care unit (ICU) admission and mortality risk. Results: Statistically significant differences were observed between CCHF patients and healthy controls in all param- eters (p<0.05). Patients admitted to the ICU or those who did not survive exhibited a significant increase in all plate - let-normalized ratios (p<0.05), except ALT/Plt. ROC analysis revealed that IL-6/Plt (AUC=0.998, cut-off>0.018, sensitivi- ty=98.3%, specificity=100%) and D-dimer/Plt (AUC=0.992, cut-off>0.002, sensitivity=95%, specificity=96.7%) had the highest diagnostic accuracy for CCHF. Furthermore, IL-6/Plt and D-dimer/Plt ratios also showed high predictive accura- cy for predicting the need for ICU admission and mortality risk. Conclusion: Platelet-normalized biomarkers, particularly IL-6/Plt and D-dimer/Plt, demonstrate strong diagnostic and prognostic potential for CCHF. Their inclusion in clinical protocols could improve early detection, risk assessment and treatment decisions for CCHF patients.
