{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T18:45:05Z","timestamp":1793040305337,"version":"4.5.0"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,11,12]],"date-time":"2020-11-12T00:00:00Z","timestamp":1605139200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1 TR001863"],"award-info":[{"award-number":["UL1 TR001863"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Apheresis"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The association between parasite burden and end\u2010organ dysfunction in subjects with <jats:italic>Babesia microti<\/jats:italic> infection has not been extensively studied, nor has the optimal role of red blood cell exchange (RCE) transfusion in babesiosis treatment. This retrospective chart review evaluates the associations between parasitemia, end\u2010organ dysfunction, and outcomes in babesiosis patients treated with antimicrobial agents and RCE compared to those treated with antimicrobial agents alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>We evaluated adults (\u226518\u2009years of age) with laboratory\u2010confirmed babesiosis who were admitted between 2011 and 2017 to Yale New Haven Hospital, located in a <jats:italic>Babesia<\/jats:italic>\u2010endemic region of the Northeastern United States. Patient demographics, parasitemia levels, clinical and laboratory indicators of end\u2010organ dysfunction, and outcomes were examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ninety\u2010one subjects (mean age 65.1\u2009years, 69.2% male) were studied. Subjects were stratified according to peak parasitemia: &lt;1% (n = 34), 1\u20105% (n = 24), 5\u201010% (n = 15), and &gt;10% (n = 18). Laboratory measures indicating degrees of hemolysis, coagulopathy, and pulmonary, renal and hepatic dysfunction differed significantly across peak parasitemia levels. Median length of hospital stay increased with each successive peak parasitemia level (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). These results indicate a strong association between peak parasitemia level and disease severity. Nineteen subjects underwent RCE, all with peak parasitemia \u22659% and some degree of end\u2010organ dysfunction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:italic>Babesia microti<\/jats:italic> parasitemia is closely associated with disease severity, though not all subjects with end\u2010organ dysfunction had high\u2010grade parasitemia. Our data suggest that the use of parasitemia &gt;10%, coupled with clinical status, is a reasonable indicator for RCE in babesiosis patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jca.21853","type":"journal-article","created":{"date-parts":[[2020,11,12]],"date-time":"2020-11-12T13:13:10Z","timestamp":1605186790000},"page":"127-134","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Parasite burden and red blood cell exchange transfusion for babesiosis"],"prefix":"10.1002","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2909-8200","authenticated-orcid":false,"given":"Jane","family":"O'Bryan","sequence":"first","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Sciences Yale University School of Medicine  New Haven Connecticut 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