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Background <p>Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne viral illness associated with substantial acute mortality, but its longer-term somatic sequelae remain poorly characterized. We assessed the one-year trajectories of residual and late-onset symptoms after SFTS and explored their clinical correlates.</p> Methods <p>Ten hospitals in Japan participated, and nine enrolled SFTS survivors. In retrospective face-to-face interviews, participants rated 25 symptoms at onset and at 1, 3, 6, and 12 months after illness onset using a five-point Likert scale. The questionnaire comprised the Somatic Symptom Scale-8 (SSS-8) plus additional SFTS-relevant items. Mixed-effects models were used to evaluate longitudinal changes in total SSS-8 scores according to sex and age. Univariable logistic regression analyses were performed for individual symptom items using sex, age, body mass index, and maximum Sequential Organ Failure Assessment (SOFA) score as predictors.</p> Results <p>Among 33 participants, questionnaires were completed a median of 42 months after SFTS onset. Total SSS-8 scores declined over 12 months, from a median of 12 at onset to 4 at 1 month, 2 at 3 and 6 months, and 0 at 12 months. However, 30/33 participants (91%) reported at least one residual or late-onset symptom during months 1–12, and 2/25 participants (8%) still had an SSS-8 score ≥ 8 at 12 months. Representative residual symptoms included feeling tired or having low energy and pain in the arms, legs, or joints. In contrast, weight loss, hair loss, and visual disturbances or eye problems were retrospectively reported more frequently after the acute phase. Older age was associated with higher SSS-8 scores, whereas age-adjusted scores declined more rapidly in female participants. Higher body mass index and higher maximum SOFA score were associated with selected symptoms.</p> Conclusions <p>Residual and retrospectively reported late-onset somatic symptoms were common in this cohort. Larger prospective studies including younger and milder cases should use repeated contemporaneous assessments and evaluate functional and quality-of-life outcomes together with virological and immunological correlates.</p>

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Trajectories of residual and late-onset somatic symptoms of severe fever with thrombocytopenia syndrome: Insights from a multicenter questionnaire study in western Japan

  • 期刊论文

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  • 发表日期：

    2026年7月31日

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  • Ryuichi Minoda Sada,
  • Shungo Yamamoto,
  • Takao Toyokawa,
  • Toru Takahashi,
  • Atsushi Yamanaka,
  • Masafumi Kawamura,
  • Kyoko Yokota,
  • Yusuke Fukumori,
  • Tomohiro Taniguchi,
  • Ryutaro Tanizaki,
  • Kentaro Iwata,
  • Shigetoshi Sakabe,
  • Shu Kiyotoki,
  • Satoshi Kutsuna

摘要

Background

Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne viral illness associated with substantial acute mortality, but its longer-term somatic sequelae remain poorly characterized. We assessed the one-year trajectories of residual and late-onset symptoms after SFTS and explored their clinical correlates.

Methods

Ten hospitals in Japan participated, and nine enrolled SFTS survivors. In retrospective face-to-face interviews, participants rated 25 symptoms at onset and at 1, 3, 6, and 12 months after illness onset using a five-point Likert scale. The questionnaire comprised the Somatic Symptom Scale-8 (SSS-8) plus additional SFTS-relevant items. Mixed-effects models were used to evaluate longitudinal changes in total SSS-8 scores according to sex and age. Univariable logistic regression analyses were performed for individual symptom items using sex, age, body mass index, and maximum Sequential Organ Failure Assessment (SOFA) score as predictors.

Results

Among 33 participants, questionnaires were completed a median of 42 months after SFTS onset. Total SSS-8 scores declined over 12 months, from a median of 12 at onset to 4 at 1 month, 2 at 3 and 6 months, and 0 at 12 months. However, 30/33 participants (91%) reported at least one residual or late-onset symptom during months 1–12, and 2/25 participants (8%) still had an SSS-8 score ≥ 8 at 12 months. Representative residual symptoms included feeling tired or having low energy and pain in the arms, legs, or joints. In contrast, weight loss, hair loss, and visual disturbances or eye problems were retrospectively reported more frequently after the acute phase. Older age was associated with higher SSS-8 scores, whereas age-adjusted scores declined more rapidly in female participants. Higher body mass index and higher maximum SOFA score were associated with selected symptoms.

Conclusions

Residual and retrospectively reported late-onset somatic symptoms were common in this cohort. Larger prospective studies including younger and milder cases should use repeated contemporaneous assessments and evaluate functional and quality-of-life outcomes together with virological and immunological correlates.