t-PA/PAI-1 complex expression correlates with the severity in hantaan virus-induced hemorrhagic fever with renal syndrome.

OBJECTIVES

This study aimed to investigate t-PAIC concentration changes across severity levels in HFRS patients and evaluate its value in predicting disease severity, providing a potential biomarker for HFRS severity assessment and monitoring.

METHODS

t-PAIC levels were measured by chemiluminescence immunoassay in 156 HFRS patients and 37 healthy controls. Routine laboratory tests assessed WBC, PLT, Cr, UA, urea, HDL, ALB, APTT, and PT. HFRS-specific antibodies were detected using the colloidal gold method. Spearman correlation analysis evaluated associations between t-PAIC and clinical indices. Ordinal logistic regression identified risk factors linked to disease severity. ROC curve analysis assessed the predictive performance of t-PAIC for HFRS severity.

RESULTS

t-PAIC levels progressively increased with HFRS severity, peaking in critically ill patients. t-PAIC showed significant positive correlations with leukocyte count (r = 0.6082; p < 0.01), Cr (r = 0.3567; p < 0.01), urea (r = 0.4376; p < 0.01), UA (r = 0.3201; p < 0.01), APTT (r = 0.6182; p < 0.01), and PT (r = 0.2997; p < 0.01), and significant inverse correlations with PLT (r = -0.6177; p < 0.01), HDL (r = -0.3074; p < 0.01), and ALB (r = -0.4790; p < 0.01). ROC analysis revealed t-PAIC had good predictive value for disease severity (AUC = 0.796, 95% CI: 0.724-0.867, p < 0.001).

CONCLUSIONS

t-PAIC levels closely reflect HFRS severity and associated clinical features, including renal dysfunction and coagulation abnormalities, suggesting its potential as a biomarker for monitoring disease status.