Clinical and Immunological Predictors of Hemorrhagic Fever with Renal Syndrome Outcome during the Early Phase

Geum Young Lee, Won Keun Kim, Jin Sun No, Yongjin Yi, Hayne Cho Park, Jaehun Jung, Seungchan Cho, Jingyeong Lee, Seung Ho Lee, Kyungmin Park, Jongwoo Kim, Jin Won Song

Research output: Contribution to journalArticlepeer-review


The ability to accurately predict the early progression of hemorrhagic fever with renal syndrome (HFRS) is crucial for reducing morbidity and mortality rates in severely affected patients. However, the utility of biomarkers for predicting clinical outcomes remains elusive in HFRS. The aims of the current study were to analyze the serum levels of immune function-related proteins and identify novel biomarkers that may help ascertain clinical outcomes of HFRS. Enzyme-linked immunosorbent assay, Luminex, and bioanalyzer assays were used to quantitatively detect 15 biomarkers in 49 serum samples of 26 patients with HFRS. High hemoglobin (HGB) and low urine output (UO) levels were identified as potential biomarkers associated with the acute HFRS. The serum soluble urokinase plasminogen activator receptor (suPAR) and C-X-C motif chemokine ligand 10 (CXCL10) values increased in the early phase of diseases. Elevated suPAR, interleukin-10 (IL-10), CXCL10, and decreased transforming growth factor-beta 3 (TGF-β3) were representative predictors of the disease severity. Upregulation of the HGB showed a significant correlation with high levels of suPAR and CXCL10. Reduced UO positively correlated with increased suPAR, CXCL10, and TGF-β2, and decreased vascular endothelial growth factor and TGF-β3. The changing HGB and UO criteria, high suPAR, IL-10, CXCL10, and low TGF-β3 of HFRS raise significant awareness for physicians regarding prospective biomarkers for monitoring early warning signs of HFRS. This study provides critical insights into the clinical and immunological biomarkers for disease severity and progression in patients with HFRS to identify early predictions of fatal outcomes.

Original languageEnglish
Article number595
Issue number3
Publication statusPublished - 2022 Mar

Bibliographical note

Funding Information:
This work was supported by the National Research Foundation of Korea (NRF-2017M3A9E4061992) and the Agency for Defense Development (UE202026GD).

Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.


  • biomarker
  • early phase
  • hemorrhagic fever with renal syndrome
  • prognosis
  • severity

ASJC Scopus subject areas

  • Infectious Diseases
  • Virology


Dive into the research topics of 'Clinical and Immunological Predictors of Hemorrhagic Fever with Renal Syndrome Outcome during the Early Phase'. Together they form a unique fingerprint.

Cite this