Infectious Disease Center, Beijing Ditan Hospital Capital Medical University, Beijing, China.
Department of Microbiology, Peking University School of Basic Medical Science, Beijing, China.
Epidemiol Infect. 2020 Feb 27;148:e44. doi: 10.1017/S0950268819002279.
In recent years, outbreaks of hand-foot-mouth disease (HFMD) in China, Singapore and other Western Pacific Region, involving millions of children, have become a big threat to public health. This study aimed to quantitatively assess all qualified studies and identify the risk factors for HFMD death. A systematic search of the databases PubMed, Medline, Embase and the Cochrane Library was performed. Study heterogeneity and publication bias were estimated. Seven case-control studies involving 1641 participants (634 died and 1007 survived) were included in the meta-analysis. Human enterovirus 71 infection, male, age ⩽3 years, vomiting, cyanosis, convulsion, duration of fever ⩾3 days, atypical rashes and abdominal distention were not significantly related to HFMD death (P ⩽ 0.05). Lethargy (odds ratio (OR) = 6.62; 95% CI 3.61-12.14; I2 = 0%; P < 0.0001), pneumonoedema/pneumorrhagia (OR = 4.09; 95% CI 2.44-6.87; I2 = 0%; P < 0.0001), seizures (OR = 6.85; 95% CI 2.37-19.74; I2 = 0%; P = 0.0004), dyspnoea (OR = 8.24; 95% CI 2.05-33.19; I2 = 83%; P = 0.003) and coma (OR = 3.76; 95% CI 1.85-7.67; I2 = 0%; P = 0.0003) were significantly associated with HFMD death, which were risk factors for HFMD death.
近年来，中国、新加坡等西太平洋地区手足口病（HFMD）爆发，涉及数百万儿童，对公众健康构成了巨大威胁。本研究旨在定量评估所有合格研究，并确定 HFMD 死亡的危险因素。系统检索了 PubMed、Medline、Embase 和 Cochrane Library 数据库。估计了研究异质性和发表偏倚。纳入了 7 项病例对照研究，共涉及 1641 名参与者（634 人死亡，1007 人存活）进行荟萃分析。人肠道病毒 71 感染、男性、年龄 ⩽3 岁、呕吐、发绀、抽搐、发热 ⩾3 天、不典型皮疹和腹胀与 HFMD 死亡无显著相关性（P ⩽0.05）。昏睡（比值比（OR）=6.62；95%可信区间 3.61-12.14；I2=0%；P<0.0001）、肺水肿/肺出血（OR=4.09；95%可信区间 2.44-6.87；I2=0%；P<0.0001）、抽搐（OR=6.85；95%可信区间 2.37-19.74；I2=0%；P=0.0004）、呼吸困难（OR=8.24；95%可信区间 2.05-33.19；I2=83%；P=0.003）和昏迷（OR=3.76；95%可信区间 1.85-7.67；I2=0%；P=0.0003）与 HFMD 死亡显著相关，是 HFMD 死亡的危险因素。
