The recent publication in Acta Tropica shines a spotlight on the promising role of hepatic fibrosis indices in predicting the severity and outcomes of Crimean-Congo Hemorrhagic Fever (CCHF), particularly in the allocation of intensive care resources and acting as an early warning system for patient mortality. This ground-breaking research, led by Bolat Serkan and a team of medical experts, provides new insights into non-invasive prediction models that could significantly impact the management of this acute viral hemorrhagic disease.

Crimean-Congo Hemorrhagic Fever: A Global Threat

CHF is known for its sudden onset and potentially fatal consequences, with its spread characterized by tick bites or direct contact with the blood of infected animals or humans. Recognized by the World Health Organization as a dangerous pathogen requiring strict containment protocols, CCHF has a mortality rate of up to 40%, depending on the outbreak region. Accurate early diagnosis and prognostic assessment are crucial in preventing its spread and managing the disease.

Emergence of Hepatic Fibrosis Indices in CCHF Prognosis

In a landmark study published on January 11, 2024, titled “Analysis of liver fibrosis equations as a potential role of predictive models in Crimean-Congo hemorrhagic fever,” researchers explored the viability of using hepatic fibrosis equations to anticipate ICU needs and fatality risks in CCHF patients.

The study (DOI: 10.1016/j.actatropica.2024.107121) enrolled 194 patients with confirmed CCHF across Turkey. The research, under the auspices of Sivas Cumhuriyet University and Erciyes University, probed 14 liver fibrosis indices, performing analyses to determine their predictive power.

Non-Invasive Indices: A Ray of Hope

The article highlights the potential of serum biomarkers as a non-invasive method for evaluating liver fibrosis, which is of particular importance in CCHF where liver involvement is common. The indices were determined based on previously established formulas, which took into account various factors such as age, gender, laboratory findings, and other relevant measures to derive an assessment of the liver’s condition.

Pioneering Findings

Among the indices tested, the study found that the S-INDEX, KING, and GPRI had significant predictive value. The tdROC analyses returned high area under the curve (AUC) statistics for these indices—0.920, 0.913, and 0.909, respectively—when predicting ten-day survival rates among the patients.

The study’s findings suggest that the KING, Goteborg University cirrhosis index (GUCI), and GPRI scores held predictive value for estimating ICU requirements up to ten days. Notably, the KING index was identified as a potential early predictor for both ICU admissions and ten-day survival, with compelling baseline statistics.

The Implications and Future Directions

The promising results from this study indicate that these non-invasive indices can be crucial tools in stratifying patients according to risk, allowing healthcare workers to make informed decisions quickly. In the context of a CCHF outbreak, this can mean the difference between life and death.

The research team, comprising Serkan Bolat, Seyit Ali Büyüktuna, Funda İpekten, Kübra Doğan, Gökmen Zararsız, and Halef Okan Doğan, acknowledges that while the findings are promising, further research and validation would be necessary to confirm and potentially extend the application of hepatic fibrosis indices in the clinical scenario.

The full article, available in Volume 251 of Acta Tropica, not only adds a significant chapter to the medical field’s understanding of CCHF but also opens doors for improved patient outcomes through the adaptation of the indices in clinical practice. The study underscores the need for continuous research into non-invasive diagnostic tools in the fight against high-mortality infectious diseases.

Declaration of Interests
The authors declare no known competing financial interests or personal relationships that could influence the reported work, ensuring the integrity and objectivity of their research.


1. Bolat, S. et al. (2024). Analysis of liver fibrosis equations as a potential role of predictive models in Crimean-Congo hemorrhagic fever. Acta Trop, 251, 107121. DOI: 10.1016/j.actatropica.2024.107121
2. Ergonul, O. (2006). Crimean-Congo haemorrhagic fever. The Lancet Infectious Diseases, 6(4), 203-214.
3. World Health Organization. (2013). Crimean-Congo hemorrhagic fever (CCHF). Retrieved from
4. Whitehouse, C. A. (2004). Crimean–Congo Hemorrhagic Fever. Antiviral research, 64(3), 145-160.
5. Hoofnagle, J. H., & Doo, E. (2002). The role of non-invasive tests of fibrosis in managing chronic liver disease. Journal of Hepatology, 37(4), 574-583.


1. Crimean-Congo Hemorrhagic Fever prognosis
2. CCHF intensive care prediction
3. Hepatic fibrosis indices CCHF
4. Non-invasive liver fibrosis CCHF
5. Serum biomarkers CCHF