Dyslipidemia in severe fever with thrombocytopenia syndrome patients: A retrospective cohort study

Background: Severe fever with thrombocytopenia syndrome (SFTS) is a rapidly progressive infectious disease triggered by a novel bunyavirus (SFTSV). Despite the critical role of host lipid metabolism in viral infections, research on dyslipidemia in SFTS remains limited.Methods: This retrospective study included 433 SFTS patients, who were stratified into survival group (n = 365) and death group (n = 68) and who were treated at the Shandong Public Health Clinical Center from September 2021 to December 2023. Additionally, 96 healthy controls with matching baseline characteristics were included from Shandong Provincial Hospital. Cross-sectional analysis based on admission data and longitudinal analysis over time were employed to survey the correlation between serum lipid profiles and mortality in SFTS patients.Results: SFTS patients exhibited elevated triglyceride (TG) levels and reduced total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels compared to healthy individuals. Cross-sectional analysis demonstrated that lower LDL-C and apolipoprotein-B (ApoB) levels were related to elevated mortality risk in SFTS patients. Longitudinal analysis demonstrated that LDL-C and ApoB levels remained consistently lower in the death group, while TG levels gradually declined, and HDL-C levels gradually increased as the disease progressed.Conclusion: SFTS patients exhibit significant dyslipidemia compared to healthy individuals. Lower LDL-C and ApoB levels may independently influence mortality in SFTS patients. Elevated TG and reduced HDL-C levels may associate with disease progression.