SFTSV-encoded microRNA-like small RNA as prognostic biomarkers in severe fever with thrombocytopenia syndrome

Sep 30, 2026

Uploaded by jay

Severe fever with thrombocytopenia syndrome (SFTS) is a highly fatal infection caused by SFTS virus (SFTSV), yet specific prognostic markers for SFTSV infection remain insufficient. This study identified SFTSV-encoded microRNA-like small RNAs (milRNAs) in patient sera and assessed prognostic value using a multi-phase cohort and expression dynamics across disease stages. Three milRNAs were significantly elevated in severe cases and nearly undetectable in mild cases and healthy controls. Higher milRNA levels predicted shorter survival and outperformed traditional immune cell indicators for severity prediction.

LanguageEnglish

CategoryHealthcare

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Pages12

Reading Time30 min

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Abstract

Study design and methods

Key findings and prognostic performance

Keywords

Emerging Microbes & Infections 2026, VOL. 15, 2608405 (12 pages) [https://doi.org/10.1080/22221751.2025.2608405](https://doi.org/10.1080/22221751.2025.2608405) SFTSV-encoded microRNA-like small RNA as prognostic biomarkers in severe fever with thrombocytopenia syndrome Xiao Hua*, Yu Gengd*, Lingyan Shena*, Chenyu Taoa, Feng Wanga, Hongyuan Guoa, Xi Chena, b, Yuxin Chend and Zheng Fua,c aNanjing Drum Tower Hospital Center of Molecular Diagnostic and Therapy, State Key Laboratory of Pharmaceutical Biotechnology, Jiangsu Engineering Research Center for MicroRNA Biology and Biotechnology, NJU Advanced Institute of Life Sciences (NAILS), School of Life Sciences, Nanjing University, Nanjing, People’s Republic of China; bResearch Unit of Extracellular RNA, Chinese Academy of Medical Sciences, Nanjing, People’s Republic of China; cTianfu Jincheng Laboratory, Chengdu, People’s Republic of China; dDepartment of Laboratory Medicine, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, People’s Republic of China ABSTRACT Severe fever with thrombocytopenia syndrome (SFTS) is a highly fatal infectious disease caused by the SFTS virus (SFTSV) . Reliable prognostic biomarkers are essential for early intervention, yet specific markers for SFTSV infection remain unidentified. In this study, we identified SFTSV-encoded microRNA-like small RNAs (milRNAs) in patients’ sera and evaluated their potential as prognosis biomarker. A multi-phase study involving 170 laboratory-confirmed SFTS patients, 40 patients with other infection and 80 healthy controls was conducted. Small RNA deep sequencing was performed, followed by quantitative reverse transcription polymerase chain reaction (qRT-PCR) and TA cloning for individual validation. The expression dynamics of identified milRNAs were analyzed across different disease stages, and their prognostic potential was assessed using Kaplan-Meier survival analysis and Cox proportional hazards regression. Three SFTSV-encoded milRNAs – SFTSV-S-1480 (S-1480), SFTSV-M-692 (M-692), and SFTSV-L-4706 (L-4706) – were significantly elevated in the sera of severe patients but were nearly undetectable in mild cases and healthy controls. Their expression levels increased notably during the multiple organ dysfunction (MOD) stage, correlating with disease progression. Patients with higher milRNA expression had significantly shorter survival compared to those with lower expression. Receiver operating characteristic (ROC) curve analysis demonstrated that the three-milRNA panel outperformed traditional blood immune cell indicators in predicting disease severity. Our study identifies a panel of three SFTSV-encoded milRNAs as novel prognostic biomarkers for SFTS. Their strong correlation with disease progression and clinical outcomes suggests their potential utility for early risk stratification and targeted intervention. ARTICLE HISTORY Received 5 September 2025; Revised 4 December 2025; Accepted 18 December 2025 KEYWORDS Severe fever with thrombocytopenia syndrome (SFTS); SFTS virus (SFTSV); virus-encoded microRNA-like small RNAs; prognostic biomarkers; severity stratification Introduction Severe fever with thrombocytopenia syndrome (SFTS) is an emerging life-threatening infectious disease first identified in rural areas of China in 2009, with subsequent reports in various East Asian regions [ 1, 2] . The SFTS causative pathogen, SFTS virus (SFTSV), has been officially named Dabie bandavirus, comprising a segmented, negative-strand RNA that includes large (L), medium (M), and small (S) segments [3] . This virus belongs to the genus bandavirus of the family phenuiviridae, order Bunyavirales. Tick-tohuman transmission is the primary route by which people are infected with SFTSV, and human-tohuman transmission has also been frequently reported [4] . Therefore, the World Health Organization has listed SFTSV as one of the highest priority pathogens that warrant resear

FAQs

What problem does the study address about SFTSV infection?

Reliable prognostic biomarkers are needed for early intervention, but specific markers for SFTSV infection had not been identified prior to this work.

How were the SFTSV-encoded microRNA-like small RNAs validated?

Identified milRNAs were validated by qRT-PCR and TA cloning, after small RNA deep sequencing, in a multi-phase cohort of SFTS patients, other infection controls, and healthy controls.

Which milRNAs showed prognostic value and how did they relate to disease severity?

SFTSV-S-1480, SFTSV-M-692, and SFTSV-L-4706 were significantly elevated in severe patients, increased during the multiple organ dysfunction stage, and predicted shorter survival; a three-milRNA panel improved prediction of disease severity.

Sep 30, 2026

Uploaded by jay