{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T22:56:16Z","timestamp":1793055376593,"version":"4.5.0"},"reference-count":38,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,6,20]],"date-time":"2021-06-20T00:00:00Z","timestamp":1624147200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Competitive State Research Financing of the Expert Responsibility Area of Tampere University Hospital","award":["9X033 and 9V040"],"award-info":[{"award-number":["9X033 and 9V040"]}]},{"DOI":"10.13039\/501100006306","name":"Sigrid Jus\u00e9liuksen S\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","award":["MS568"],"award-info":[{"award-number":["MS568"]}],"id":[{"id":"10.13039\/501100006306","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006706","name":"Tampereen Tuberkuloosis\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","award":["MS 759"],"award-info":[{"award-number":["MS 759"]}],"id":[{"id":"10.13039\/501100006706","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002341","name":"Academy of Finland","doi-asserted-by":"publisher","award":["321809"],"award-info":[{"award-number":["321809"]}],"id":[{"id":"10.13039\/501100002341","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004155","name":"Magnus Ehrnroothin S\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","award":["-"],"award-info":[{"award-number":["-"]}],"id":[{"id":"10.13039\/501100004155","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Puumala hantavirus (PUUV) causes a hemorrhagic fever with renal syndrome characterized by thrombocytopenia, increased capillary leakage, and acute kidney injury (AKI). As glucosuria at hospital admission predicts the severity of PUUV infection, we explored how plasma glucose concentration associates with disease severity. Plasma glucose values were measured during hospital care in 185 patients with PUUV infection. They were divided into two groups according to maximum plasma glucose concentration: P-Gluc &lt; 7.8 mmol\/L (n = 134) and P-Gluc \u2265 7.8 mmol\/L (n = 51). The determinants of disease severity were analyzed across groups. Patients with P-Gluc \u22657.8 mmol\/L had higher hematocrit (0.46 vs. 0.43; p &lt; 0.001) and lower plasma albumin concentration (24 vs. 29 g\/L; p &lt; 0.001) than patients with P-Gluc &lt; 7.8 mmol\/L. They presented with higher prevalence of pulmonary infiltrations and pleural effusion in chest radiograph, higher prevalence of shock and greater weight change during hospitalization. Patients with P-Gluc \u2265 7.8 mmol\/L were characterized by lower platelet count (50 vs. 66 \u00d7 109\/L; p = 0.001), more severe AKI (plasma creatinine 272 vs. 151 \u00b5mol\/L; p = 0.001), and longer hospital treatment (8 vs. 6 days; p &lt; 0.001) than patients with P-Gluc &lt; 7.8 mmol\/L. Plasma glucose level is associated with the severity of capillary leakage, thrombocytopenia, inflammation, and AKI in patients with acute PUUV infection.<\/jats:p>","DOI":"10.3390\/v13061177","type":"journal-article","created":{"date-parts":[[2021,6,20]],"date-time":"2021-06-20T21:50:15Z","timestamp":1624225815000},"page":"1177","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The Clinical Presentation of Puumala Hantavirus Induced Hemorrhagic Fever with Renal Syndrome Is Related to Plasma Glucose Concentration"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1882-0691","authenticated-orcid":false,"given":"Johanna","family":"Tiet\u00e4v\u00e4inen","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland"},{"name":"Department of Internal Medicine, Tampere University Hospital, 33520 Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6967-2401","authenticated-orcid":false,"given":"Satu","family":"M\u00e4kel\u00e4","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland"},{"name":"Department of Internal Medicine, Tampere University Hospital, 33520 Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1372-430X","authenticated-orcid":false,"given":"Heini","family":"Huhtala","sequence":"additional","affiliation":[{"name":"Faculty of Social Sciences, Tampere University, 33520 Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4905-7564","authenticated-orcid":false,"given":"Ilkka H.","family":"P\u00f6rsti","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland"},{"name":"Department of Internal Medicine, Tampere University Hospital, 33520 Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2454-7479","authenticated-orcid":false,"given":"Tomas","family":"Strandin","sequence":"additional","affiliation":[{"name":"Department of Virology, Medicum, University of Helsinki, 00290 Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antti","family":"Vaheri","sequence":"additional","affiliation":[{"name":"Department of Virology, Medicum, University of Helsinki, 00290 Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jukka","family":"Mustonen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland"},{"name":"Department of Internal Medicine, Tampere University Hospital, 33520 Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,6,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1038\/nrmicro3066","article-title":"Uncovering the mysteries of hantavirus infections","volume":"11","author":"Vaheri","year":"2013","journal-title":"Nat. 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