TOPLINE:

Administration of ribavirin within 96 hours of symptom onset in patients with Crimean-Congo hemorrhagic fever was associated with a reduced risk for mortality, while age 50 years or more and diabetes were risk factors for mortality.

METHODOLOGY:

• Researchers conducted a retrospective analysis to assess the predictors of mortality and effect of early ribavirin administration in patients with CCHF.
• They included data from 1103 patients with CCHF (median age, 53 years; 65.7% men) across 18 hospitals in endemic regions of Turkey between January 2019 and November 2024.
• Participants were required to have clinical suspicion of CCHF and laboratory-confirmed infection via positive reverse transcription polymerase chain reaction results.
• The primary outcome was in-hospital mortality, with particular focus on the timing of ribavirin initiation as the main exposure and other associated factors affecting mortality.

TAKEAWAY:

• Among hospitalized patients, 8.0% were admitted to the ICU, and the overall mortality rate was 5.1%. Healthcare-related infections developed in 4.6% of patients.
• Ribavirin administration within 96 hours of symptom onset significantly reduced the risk for in-hospital mortality by 79% (adjusted hazard ratio [aHR], 0.21; P = .010).
• Age 50 years or more (aHR, 2.56; P = .011) and presence of diabetes (aHR, 2.71; P =  .009) were associated with an increased risk for mortality.

IN PRACTICE:

“Our findings suggest a potential clinical benefit of early ribavirin administration in patients with CCHF. In this observational cohort, initiation of ribavirin within 96 hours of symptom onset was independently associated with a reduced risk of in-hospital mortality,” the authors of the study wrote.

SOURCE:

The study was led by Deniz Güllü, Koc University School of Medicine in Istanbul, Türkiye. It was published online on August 20, 2025, in Clinical Microbiology and Infection.

LIMITATIONS:

The retrospective observational design may have introduced recall bias, particularly regarding symptom onset and tick bite history. The absence of national treatment guidelines for ribavirin use in CCHF resulted in variability in treatment decisions across centers. Additionally, the oral-only formulation of ribavirin in Türkiye may have restricted its use in patients with gastrointestinal bleeding.

DISCLOSURES:

The authors reported that no funding was received for this study. Additionally, they declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.