Objective  To study the risk factors of neurological involvement in severe fever with thrombocytopenia syndrome (SFTS) patients.

Methods Patients admitted to Weifang Yidu Central Hospital from 2018 to 2022 were selected. The clinical data and laboratory test of the 2 groups were analyzed, and the risk factors of neurological involvement were analyzed by logistic regression analysis.

Results  A total of 106 patients were selected, simple group (control group, 51 patients) and neurological involvement group (experimental group, 55 patients).The cases of fever≥38.5 ℃, age≥65 years old, urinary protein≥2+, nausea and vomiting in the experimental group were significantly more than those in the control group（χ²=3.883,21.668,18.603,7.338, P=0.049＜0.05）. The average value of platelet count in the experimental group was lower than that in the control group（t=6.770, P＜0.001）; Alanine transaminase, Aspartate transaminase, Procalcitonin , Lactate dehydrogenase, Creatine kinase and Creatine kinase MB in the experimental group were higher than those in the control group and the difference between the two groups is statistically significant (Z=−1.970, −3.614, −3.048, −3.386, −4.091, −2.586; P=0.049, ＜0.001, 0.010, ＜0.001, 0.002, ＜0.001) . logistic regression analysis showed that age≥65 years old, urinary protein ≥2+ and low level of PLT were independent risk factors for neurological involvement in patients with SFTS. The risk of neurological involvement increased by 4.32 times after age ≥ 65 years old; the risk of neurological involvement increased by 5.32 times after urinary protein ≥2+; for every unit (1×10/L) of increase in PLT, the risk of neurological involvement decreased by 6.00%, that means PLT is a protective factor.

Conclusion  Aged ≥65 years old, urinary protein ≥2+ and low level of PLT were independent clinical risk factors for neurological involvement in patients with SFTS. Therefore, attention should be paid to screening the above-mentioned indexes in clinical work.