Clinical and biological presentation of patients with SCD and severe acute parvovirus B19 infection admitted to the ICU
| . | NA . | Overall . | Erythroblastopenia . | BMN / CFE . | Other VO manifestations . | P value . |
|---|---|---|---|---|---|---|
| N = 61 . | n = 26 . | n = 17 . | n = 18 . | |||
| Presentation at ICU admission | ||||||
| SAPS II | 1 | 19 (10-33) | 14 (9-20) | 35 (21-64) | 19 (6-36) | <.001 |
| SOFA | 12 | 3 (2-8) | 2 (2-3) | 11 (6-13) | 3 (2-7) | <.001 |
| ACS | 0 | 43 (70.5) | 15 (57.7) | 16 (94.1) | 12 (66.7) | .03 |
| VOC | 0 | 49 (80.3) | 19 (73.1) | 14 (82.4) | 16 (88.9) | .4 |
| Chest pain | 2 | 18 (30.5) | 6 (24) | 3 (18.8) | 9 (50) | .1 |
| Extrathoracic pain | 2 | 43 (72.9) | 16 (64) | 12 (75) | 15 (83.3) | .4 |
| Heart rate, /min | 3 | 113 (100-123) | 99 (85-112) | 123 (116-135) | 114 (110-125) | <.001 |
| Respiratory rate, /min | 9 | 23 (19-29) | 19 (17-23) | 25 (20-32) | 26 (22-30) | .01 |
| Temperature, °C | 3 | 38.4 (37.2-39.0) | 37.5 (37.0-38.9) | 39.0 (38.4-39.8) | 38.3 (37.1-38.5) | .001 |
| Mean arterial pressure, mm Hg | 8 | 85 (74-97) | 81 (71-94) | 79 (73-91) | 89 (87-108) | .02 |
| SpO2, % | 2 | 99 (96-100) | 99 (97-100) | 98 (95-99) | 99 (97-100) | .1 |
| SpO2:FiO2 ratio | 3 | 321 (238-362) | 348 (313-367) | 238 (152-291) | 333 (254-363) | .001 |
| Glasgow coma scale | 0 | 15 (14-15) | 15 (15-15) | 10 (9-15) | 15 (15-15) | <.001 |
| Pain (numerical evaluation) | 15 | 7 (2-10) | 5 (1-8) | 7 (4-10) | 9 (4-10) | .3 |
| Fever | 1 | 39 (65) | 12 (46.2) | 15 (88.2) | 12 (70.6) | .02 |
| Antibiotic | 0 | 54 (88.5) | 23 (88.5) | 16 (94.1) | 15 (83.3) | .6 |
| Biology at ICU admission | ||||||
| Hemoglobin level, g/dL | 0 | 6.6 (5.2-7.8) | 5.7 (4.0-7.1) | 6.9 (5.3-8.7) | 7.2 (5.7-8.3) | .03 |
| Platelet counts, ×109/L | 0 | 169 (61-303) | 320 (238-497.25) | 52 (37-61) | 100 (75-166) | <.001 |
| White blood cell counts, ×109/L | 3 | 13.0 (7.6-20.0) | 15.7 (8.9-26.5) | 8.3 (6.2-15.8) | 12.1 (9.6-16.6) | .1 |
| Reticulocytes, ×109/L | 5 | 29 (11-62) | 13 (4-43) | 39 (17-64) | 50 (28-125) | .01 |
| PaO2, mm Hg | 11 | 106 (80.75-152.75) | 101.50 (80-142.25) | 101 (83-153) | 132 (100.50-171.50) | .4 |
| PaCO2, mm Hg | 11 | 37.0 (31.2-41.7) | 41.0 (35.5-45.2) | 35.0 (31.0-39.0) | 34.5 (29.0-39.5) | .1 |
| FiO2, % | 17 | 32 (27-50) | 29 (21-32) | 42 (38-62) | 30 (21-40) | .01 |
| Arterial lactate level, mmol/L | 14 | 1.2 (0.8-1.9) | 0.8 (0.5-1.2) | 1.2 (1.1-2.8) | 1.3 (0.8-2.6) | .01 |
| PT, % | 10 | 63 (49-75) | 75 (63-80) | 63 (44-66) | 52 (41-56) | .001 |
| ASAT, UI/L | 1 | 156 (101-289) | 93 (44-121) | 277 (129-780) | 243 (158-323) | <.001 |
| ALAT, UI/L | 1 | 45 (30-92) | 42 (25-75) | 85 (34-188) | 45 (34-67) | .1 |
| Bilirubin, μmol/L | 1 | 32 (21-55) | 33 (18-59) | 30 (21-39) | 45 (30-71) | .3 |
| LDH, UI/L | 2 | 1662 (768-3656) | 843 (591-1738) | 3500 (2184-5438) | 1822 (750-3677) | <.001 |
| Creatinine, μmol/L | 1 | 59 (46-79) | 58 (48-73) | 80 (46-122) | 57 (42-75) | .3 |
| Parvovirus B19 serology/PCR | ||||||
| PvB19 IgG+ | 11 | 44 (88) | 19 (86.4) | 13 (86.7) | 12 (92.3) | .9 |
| PvB19 IgM+ | 10 | 35 (68.6) | 17 (77.3) | 12 (75) | 6 (46.2) | .1 |
| PvB19 PCR+ | 2 | 57 (96.6) | 25 (100) | 16 (100) | 16 (88.9) | .1 |
| PvB19 blood PCR+ | 3 | 55 (94.8) | 25 (100) | 15 (100) | 15 (83.3) | .03 |
| PvB19 viral load, log/mL | 24 | 8.2 (7.0-9.1) | 8.9 (7.0-9.4) | 7.8 (7.4-8.7) | 7.1 (3.9-8.2) | .1 |
| . | NA . | Overall . | Erythroblastopenia . | BMN / CFE . | Other VO manifestations . | P value . |
|---|---|---|---|---|---|---|
| N = 61 . | n = 26 . | n = 17 . | n = 18 . | |||
| Presentation at ICU admission | ||||||
| SAPS II | 1 | 19 (10-33) | 14 (9-20) | 35 (21-64) | 19 (6-36) | <.001 |
| SOFA | 12 | 3 (2-8) | 2 (2-3) | 11 (6-13) | 3 (2-7) | <.001 |
| ACS | 0 | 43 (70.5) | 15 (57.7) | 16 (94.1) | 12 (66.7) | .03 |
| VOC | 0 | 49 (80.3) | 19 (73.1) | 14 (82.4) | 16 (88.9) | .4 |
| Chest pain | 2 | 18 (30.5) | 6 (24) | 3 (18.8) | 9 (50) | .1 |
| Extrathoracic pain | 2 | 43 (72.9) | 16 (64) | 12 (75) | 15 (83.3) | .4 |
| Heart rate, /min | 3 | 113 (100-123) | 99 (85-112) | 123 (116-135) | 114 (110-125) | <.001 |
| Respiratory rate, /min | 9 | 23 (19-29) | 19 (17-23) | 25 (20-32) | 26 (22-30) | .01 |
| Temperature, °C | 3 | 38.4 (37.2-39.0) | 37.5 (37.0-38.9) | 39.0 (38.4-39.8) | 38.3 (37.1-38.5) | .001 |
| Mean arterial pressure, mm Hg | 8 | 85 (74-97) | 81 (71-94) | 79 (73-91) | 89 (87-108) | .02 |
| SpO2, % | 2 | 99 (96-100) | 99 (97-100) | 98 (95-99) | 99 (97-100) | .1 |
| SpO2:FiO2 ratio | 3 | 321 (238-362) | 348 (313-367) | 238 (152-291) | 333 (254-363) | .001 |
| Glasgow coma scale | 0 | 15 (14-15) | 15 (15-15) | 10 (9-15) | 15 (15-15) | <.001 |
| Pain (numerical evaluation) | 15 | 7 (2-10) | 5 (1-8) | 7 (4-10) | 9 (4-10) | .3 |
| Fever | 1 | 39 (65) | 12 (46.2) | 15 (88.2) | 12 (70.6) | .02 |
| Antibiotic | 0 | 54 (88.5) | 23 (88.5) | 16 (94.1) | 15 (83.3) | .6 |
| Biology at ICU admission | ||||||
| Hemoglobin level, g/dL | 0 | 6.6 (5.2-7.8) | 5.7 (4.0-7.1) | 6.9 (5.3-8.7) | 7.2 (5.7-8.3) | .03 |
| Platelet counts, ×109/L | 0 | 169 (61-303) | 320 (238-497.25) | 52 (37-61) | 100 (75-166) | <.001 |
| White blood cell counts, ×109/L | 3 | 13.0 (7.6-20.0) | 15.7 (8.9-26.5) | 8.3 (6.2-15.8) | 12.1 (9.6-16.6) | .1 |
| Reticulocytes, ×109/L | 5 | 29 (11-62) | 13 (4-43) | 39 (17-64) | 50 (28-125) | .01 |
| PaO2, mm Hg | 11 | 106 (80.75-152.75) | 101.50 (80-142.25) | 101 (83-153) | 132 (100.50-171.50) | .4 |
| PaCO2, mm Hg | 11 | 37.0 (31.2-41.7) | 41.0 (35.5-45.2) | 35.0 (31.0-39.0) | 34.5 (29.0-39.5) | .1 |
| FiO2, % | 17 | 32 (27-50) | 29 (21-32) | 42 (38-62) | 30 (21-40) | .01 |
| Arterial lactate level, mmol/L | 14 | 1.2 (0.8-1.9) | 0.8 (0.5-1.2) | 1.2 (1.1-2.8) | 1.3 (0.8-2.6) | .01 |
| PT, % | 10 | 63 (49-75) | 75 (63-80) | 63 (44-66) | 52 (41-56) | .001 |
| ASAT, UI/L | 1 | 156 (101-289) | 93 (44-121) | 277 (129-780) | 243 (158-323) | <.001 |
| ALAT, UI/L | 1 | 45 (30-92) | 42 (25-75) | 85 (34-188) | 45 (34-67) | .1 |
| Bilirubin, μmol/L | 1 | 32 (21-55) | 33 (18-59) | 30 (21-39) | 45 (30-71) | .3 |
| LDH, UI/L | 2 | 1662 (768-3656) | 843 (591-1738) | 3500 (2184-5438) | 1822 (750-3677) | <.001 |
| Creatinine, μmol/L | 1 | 59 (46-79) | 58 (48-73) | 80 (46-122) | 57 (42-75) | .3 |
| Parvovirus B19 serology/PCR | ||||||
| PvB19 IgG+ | 11 | 44 (88) | 19 (86.4) | 13 (86.7) | 12 (92.3) | .9 |
| PvB19 IgM+ | 10 | 35 (68.6) | 17 (77.3) | 12 (75) | 6 (46.2) | .1 |
| PvB19 PCR+ | 2 | 57 (96.6) | 25 (100) | 16 (100) | 16 (88.9) | .1 |
| PvB19 blood PCR+ | 3 | 55 (94.8) | 25 (100) | 15 (100) | 15 (83.3) | .03 |
| PvB19 viral load, log/mL | 24 | 8.2 (7.0-9.1) | 8.9 (7.0-9.4) | 7.8 (7.4-8.7) | 7.1 (3.9-8.2) | .1 |
Estimated FiO2 = ambient FiO2 (eg, 0.21) + 0.03 × O2 flow rate (L/min).19
+, positive; ALAT, alanine amino-transferase; ASAT, aspartate aminotransferase; FiO2, fraction of inspired O2; IgM/G, immunoglobulin M/G; PCR, polymerase chain reaction; PvB19, parvovirus B19; PT, prothrombin time; SOFA, sepsis-related organ failure assessment; SpO2, oxygen peripheral saturation; VO, vaso-occlusive; WBC, white blood cell.