PMID- 32754560
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200928
IS  - 2296-2360 (Print)
IS  - 2296-2360 (Electronic)
IS  - 2296-2360 (Linking)
VI  - 8
DP  - 2020
TI  - Prevalence and Management of Severe Hand, Foot, and Mouth Disease in Xiangyang, 
      China, From 2008 to 2013.
PG  - 323
LID - 10.3389/fped.2020.00323 [doi]
LID - 323
AB  - Therapeutic strategies for severe hand, foot, and mouth disease (HFMD) are 
      currently either inconsequent or deficient in evidence. We retrospectively 
      surveyed HFMD outbreaks in Xiangyang from June 2008 to December 2013. HFMD is 
      staged from I to V according to clinical severity. Severe HFMD is defined as a 
      case involving the central nervous system (CNS). We analyzed risk factors for 
      fatality of severe cases and compared the efficiency and outcome of some 
      therapies by binary logistic regression. The overall HFMD cases included 637 
      (1.26%) severe cases and 38 fatalities (0.075%). Analyses indicate that age (<3 
      years), enterovirus 71 (+), autonomic nervous system dysregulation, pulmonary 
      edema/hemorrhage, C-reactive protein (CRP) (>40 mg/L), and cardiac troponin I 
      (>0.04 ng/ml) are risk factors for fatality (all P < 0.05). Intravenous 
      immunoglobulin (IVIG) and mechanical ventilation applied only in early stage IV 
      significantly improved HFMD progression (both P < 0.05) with odds ratios of 0.24 
      (95% CI: 0.10-0.57) and 0.01 (95% CI: 0.00-0.10), respectively. Neither 
      methylprednisolone nor milrinone administered in any stage made any significant 
      difference on mortality (all P > 0.05). Precise recognition of the severe HFMD 
      cases in early stage IV and prompt IVIG and mechanical ventilation application 
      may reduce mortality. Mechanical ventilation training programs and dispatch of 
      specialists to hospitals where there is no chance of transferring critical cases 
      to the severe HFMD designated hospitals are two key measures to reduce fatality.
CI  - Copyright (c) 2020 Liu and Qi.
FAU - Liu, Jian
AU  - Liu J
AD  - Department of Pediatrics, The Second School of Clinical Medicine, Affiliated 
      Baoan Hospital of Shenzhen, Southern Medical University, Guangzhou, China.
AD  - Department of Pediatrics, The Second Affiliated Hospital of Shenzhen University, 
      Shenzhen, China.
FAU - Qi, Jing
AU  - Qi J
AD  - Department of Neurology, Affiliated Baoan Hospital of Shenzhen, Southern Medical 
      University, Guangzhou, China.
LA  - eng
PT  - Journal Article
DEP - 20200710
PL  - Switzerland
TA  - Front Pediatr
JT  - Frontiers in pediatrics
JID - 101615492
PMC - PMC7366859
OTO - NOTNLM
OT  - contagious disease
OT  - coxsackievirus A16
OT  - hand, foot, mouth disease
OT  - human enterovirus 71
OT  - lung-protective ventilation
EDAT- 2020/08/06 06:00
MHDA- 2020/08/06 06:01
PMCR- 2020/07/10
CRDT- 2020/08/06 06:00
PHST- 2019/12/16 00:00 [received]
PHST- 2020/05/18 00:00 [accepted]
PHST- 2020/08/06 06:00 [entrez]
PHST- 2020/08/06 06:00 [pubmed]
PHST- 2020/08/06 06:01 [medline]
PHST- 2020/07/10 00:00 [pmc-release]
AID - 10.3389/fped.2020.00323 [doi]
PST - epublish
SO  - Front Pediatr. 2020 Jul 10;8:323. doi: 10.3389/fped.2020.00323. eCollection 2020.