The correlation between the presence of viremia and clinical severity in patients with enterovirus 71 infection: A multi-center cohort study
Journal
BMC Infectious Diseases
Journal Volume
14
Journal Issue
1
Pages
417
Date Issued
2014
Author(s)
Abstract
Background: Enterovirus 71 (EV71) is a great disease burden across the whole world, particularly in Southeast Asia. However, in recent decades, the pathogenesis of severe EV71 infection was not well understood. This study was aimed to investigate the correlation between the presence of viremia and the clinical severity of EV71 infection. Methods: We organized a prospective cohort study and enrolled laboratory-confirmed EV71 cases in six tertiary care hospitals in Taiwan during the EV71 epidemic from 2011 to 2012. Blood samples were collected once in the acute stage, on the first day of admission. We used real-time RT-PCR to detect EV71 viremia. Demographical and clinical data were collected and the clinical severity was categorized into four grades. Data analysis was performed to identify the risk factors of viremia and the correlation between viremia and clinical severity of EV71 infection. Results: Of the total 224 enrolled patients, 59 (26%) patients were confirmed to have viremia. Two-thirds (68%) of viremic cases were detected within the first three days of infection. Viremia occurred more frequently in children under the age of one year old (odds ratios [OR] 4.82, p < 0.001) but the association between the presence of viremia and complicated EV71 infection was not found (OR 1.02, p = 0.96). In the viremia group, patients had significantly more severe complications if viremia was detected after the third day of disease onset (26% vs. 5%, p = 0.03). Conclusions: Viremia occurred more frequently in children under the age of one year and viremia detected beyond three days after the onset of disease correlated with more severe disease in EV71 patients. ? 2014 Cheng et al.; licensee BioMed Central Ltd.
SDGs
Other Subjects
adolescent; Article; blood sampling; child; cohort analysis; controlled study; disease association; disease severity; embryo; Enterovirus 71 infection; Enterovirus infection; female; human; human cell; major clinical study; male; nonhuman; onset age; prospective study; reverse transcription polymerase chain reaction; risk factor; Taiwan; viremia; article; classification; Enterovirus; Enterovirus infection; epidemic; genetics; infant; isolation and purification; multicenter study; preschool child; real time polymerase chain reaction; severity of illness index; Taiwan; viremia; virology; Adolescent; Child; Child, Preschool; Cohort Studies; Enterovirus A, Human; Enterovirus Infections; Epidemics; Female; Humans; Infant; Male; Prospective Studies; Real-Time Polymerase Chain Reaction; Risk Factors; Severity of Illness Index; Taiwan; Viremia
Publisher
BioMed Central Ltd.
Type
journal article