State Key Laboratory of Environmental Health (Incubating), Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department for Infectious Disease Control and Prevention, Baoan District Center for Disease Control and Prevention, Shenzhen, China.
J Med Virol. 2020 Dec;92(12):3144-3150. doi: 10.1002/jmv.26343. Epub 2020 Aug 13.
Coxsackievirus 6 (CV-A6) has been emerging as another predominant serotype for severe hand, foot, and mouth disease (HFMD) in China, after the introduction of enterovirus 71 inactivated vaccine (EV71 vaccine) for 3 years. Data on the risk factors for severe HFMD infected with CV-A6 are limited. We interviewed the caregivers to collected data on HFMD patients who sought medical care in the People's Hospital of Baoan district, Shenzhen, from 2015 to 2017. Totally, 131 severe patients were frequency-matched by age and gender with 174 mild patients infected with CV-A6. Univariable and multivariable logistic regression analyses were conducted to analyze the risk factors for severe CV-A6 HFMD. The average age was 20.62 ± 14.18 months and 20.52 ± 12.76 months for severe and mild patients, respectively. Multivariate analyses indicated complications at birth (odds ratio [OR], 4.18; 95% confidence interval [CI]: 1.64-10.63), peak body temperature over 39°C (OR, 4.04; 95% CI: 2.29-7.10) and first-born child (OR, 2.17; 95% CI: 1.27-3.70) increased the risk of severe HFMD infected with CV-A6. Breastfeeding (OR, 0.52; 95% CI: 0.32-0.87), and washing hands after playing frequently (OR, 0.58; 95% CI: 0.34-0.97) were negatively associated with severe illness. Compared with HFMD with infection of EV-A71, complications at birth and first-born child were newly found to be associated with severe illness in HFMD patients infected with CV-A6.
柯萨奇病毒 6 型（CV-A6）在肠道病毒 71 型灭活疫苗（EV71 疫苗）引入 3 年后，已成为中国严重手足口病（HFMD）的另一种主要血清型。关于感染 CV-A6 的严重 HFMD 的危险因素的数据有限。我们对 2015 年至 2017 年在深圳市宝安区人民医院就诊的 HFMD 患者的照顾者进行了访谈，以收集数据。总共按年龄和性别与 174 例感染 CV-A6 的轻症患者进行了 131 例重症患者的频数匹配。采用单变量和多变量逻辑回归分析分析了严重 CV-A6 HFMD 的危险因素。重症和轻症患者的平均年龄分别为 20.62±14.18 个月和 20.52±12.76 个月。多变量分析表明，出生时的并发症（优势比[OR]，4.18；95%置信区间[CI]：1.64-10.63）、体温超过 39°C（OR，4.04；95%CI：2.29-7.10）和第一胎（OR，2.17；95%CI：1.27-3.70）增加了感染 CV-A6 的严重 HFMD 的风险。母乳喂养（OR，0.52；95%CI：0.32-0.87）和经常玩耍后洗手（OR，0.58；95%CI：0.34-0.97）与病情严重程度呈负相关。与感染 EV-A71 的 HFMD 相比，出生时的并发症和第一胎被发现与感染 CV-A6 的 HFMD 患者的严重疾病有关。
