The in-hospital fatality rate for hantavirus cardiopulmonary syndrome (HCPS) is 30% and 50%, with most of those dying within 48 hours of admission to hospital.[8]Centers for Disease Control and Prevention. Reported cases of hantavirus disease: hantavirus infection in the United States. 2022 May [internet publication].
https://www.cdc.gov/hantavirus/surveillance/index.html
[18]Public Health England. Andes hantavirus: epidemiology, outbreaks and guidance. 2021 May [internet publication].
https://www.gov.uk/guidance/andes-hantavirus-epidemiology-outbreaks-and-guidance
[5]Peters CJ, Khan AS. Hantavirus pulmonary syndrome: the new American hemorrhagic fever. Clin Infect Dis. 2002 May 1;34(9):1224-31.
https://academic.oup.com/cid/article/34/9/1224/463857
http://www.ncbi.nlm.nih.gov/pubmed/11941549?tool=bestpractice.com
As of January 2017, a case fatality rate of 36% has been reported based on the number of case reports in the US.[8]Centers for Disease Control and Prevention. Reported cases of hantavirus disease: hantavirus infection in the United States. 2022 May [internet publication].
https://www.cdc.gov/hantavirus/surveillance/index.html
About 40% of patients admitted to hospital will not require intubation and can be managed with supplemental oxygen and careful fluid administration.[5]Peters CJ, Khan AS. Hantavirus pulmonary syndrome: the new American hemorrhagic fever. Clin Infect Dis. 2002 May 1;34(9):1224-31.
https://academic.oup.com/cid/article/34/9/1224/463857
http://www.ncbi.nlm.nih.gov/pubmed/11941549?tool=bestpractice.com
In survivors, the cardiopulmonary phase usually lasts 2 to 4 days, followed by a diuresis phase over 12 to 24 hours resolving the pulmonary oedema.[44]Mertz GJ, Hjelle B, Crowley M, et al. Diagnosis and treatment of new world hantavirus infections. Curr Opin Infect Dis. 2006 Oct;19(5):437-42.
http://www.ncbi.nlm.nih.gov/pubmed/16940866?tool=bestpractice.com
Intubated survivors can usually be extubated within 1 week.[5]Peters CJ, Khan AS. Hantavirus pulmonary syndrome: the new American hemorrhagic fever. Clin Infect Dis. 2002 May 1;34(9):1224-31.
https://academic.oup.com/cid/article/34/9/1224/463857
http://www.ncbi.nlm.nih.gov/pubmed/11941549?tool=bestpractice.com
Survivors can usually leave the hospital within 2 weeks.[5]Peters CJ, Khan AS. Hantavirus pulmonary syndrome: the new American hemorrhagic fever. Clin Infect Dis. 2002 May 1;34(9):1224-31.
https://academic.oup.com/cid/article/34/9/1224/463857
http://www.ncbi.nlm.nih.gov/pubmed/11941549?tool=bestpractice.com
Following the resolution of cardiogenic shock there is no subsequent cardiac dysfunction (transthoracic echocardiograms performed on three patients surviving HCPS showed normal cardiac ejection fractions).[53]Hallin GW, Simpson SQ, Crowell RE, et al. Cardiopulmonary manifestations of hantavirus pulmonary syndrome. Crit Care Med. 1996 Feb;24(2):252-8.
http://www.ncbi.nlm.nih.gov/pubmed/8605797?tool=bestpractice.com