Enterovirus genomic load and disease severity among children hospitalised with hand, foot and mouth disease

Autor: Lance Turtle, Lu Long, Yibing Cheng, Malik Peiris, Yu Li, Benjamin J. Cowling, Chun Guo, Mengyao Zeng, Kai Wang, Jianli Yang, Fang Wang, Hongjie Yu, Yonghong Zhou, Chunlan Song, Peng Wu, Chongchen Zhou, Qi Qiu, Peng Cui, Lu Liang, Tianchen Zhang
Jazyk: angličtina
Rok vydání: 2020
Předmět:
0301 basic medicine
Male
Multivariate analysis
lcsh:Medicine
medicine.disease_cause
Severity of Illness Index
law.invention
0302 clinical medicine
law
Risk Factors
Medicine
Viral load
Clinical severity
Prospective cohort study
Child
Enterovirus
lcsh:R5-920
Foot-and-mouth disease
General Medicine
Intensive care unit
Hospitalization
medicine.anatomical_structure
030220 oncology & carcinogenesis
Child
Preschool
Female
Symptom Assessment
lcsh:Medicine (General)
Research Paper
medicine.medical_specialty
Adolescent
Genome
Viral
Real-Time Polymerase Chain Reaction
Serogroup
General Biochemistry
Genetics and Molecular Biology
03 medical and health sciences
stomatognathic system
Internal medicine
Throat
Humans
business.industry
lcsh:R
Infant
Viral genomic load
Odds ratio
medicine.disease
HFMD
030104 developmental biology
business
Hand
Foot and Mouth Disease
Zdroj: EBioMedicine, Vol 62, Iss, Pp 103078-(2020)
EBIOMEDICINE
EBioMedicine
ISSN: 2352-3964
Popis: Background Examining associations between viral genomic loads of enteroviruses and clinical severity is important for promoting and improving development of antiviral drugs related to hand, foot and mouth disease (HFMD). Methods Throat swabs were collected from HFMD cases at acute phase of illness using a standardized technique in a prospective study. The viral genomic load was categorized into low, medium, and high groups using parameters of real-time reverse transcription-polymerase chain reaction. The clinical severities were assessed with four indicators, respectively. Findings We analysed 1109 HFMD cases, including 538 children with CV-A6, 231 with CV-A16, 156 with EV-A71, 78 with CV-A10, 59 with CV-A4, and 47 with CV-A2. EV-A71 genomic load categories were associated with risks of diagnoses of CNS complications (p = 0.016), requiring systemic corticosteroids or IVIG (p = 0.011), intensive care unit admission (p = 0.002) and length of hospital stay over 5 days (p = 0.048). In the multivariate analyses, point estimates of adjusted odds ratio (OR) tended to increase with viral genomic loads for all four severe outcomes and ORs of highest viral genomic load were all significantly larger than one for EV-A71. Interpretation HFMD clinical severities positively associate with viral genomic loads of EV-A71 in throat swabs. Specific antiviral drugs should be developed to reduce enterovirus load and to alleviate the clinical severities for HFMD cases. Funding National Science Fund for Distinguished Young Scholars
Databáze: OpenAIRE
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