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 |
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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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