College of Public Health, Zhengzhou University, Zhengzhou, China.
College of Public Health, Xinxiang Medical University, Xinxiang, China.
PLoS One. 2022 Apr 28;17(4):e0267716. doi: 10.1371/journal.pone.0267716. eCollection 2022.
For the past few years, only a few monovalent EV71 vaccines have been developed, while other enterovirus vaccines are in short supply. We conducted a quantitative meta-analysis to explore the epidemiological characteristics, routine laboratory diagnosis, clinical signs and risk factors for hand, foot and mouth disease (HFMD).
PubMed, Embase and the Web of Science were searched for eligible reports published before April 16, 2021, with no publication time or language restrictions. The primary outcome was the odds ratio of the epidemiological characteristics, routine laboratory diagnosis, and clinical signs associated with HFMD severity and death.
After screening 10522 records, we included 32 articles comprising 781903 cases of hand, foot and mouth disease. Patients with severe illness developed some clinical signs (hypersomnia (OR = 21.97, 95% CI: 4.13 to 116.74), convulsion (OR = 16.18, 95% CI: 5.30 to 49.39), limb shaking (OR = 47.96, 95% CI: 15.17 to 151.67), and breathlessness (OR = 7.48, 95% CI: 1.90 to 29.40)) and had some changes in laboratory parameters (interleukin-6 levels standardized mean difference (SMD) = 1.57, 95%CI: 0.55 to 2.60), an increased neutrophils ratio (SMD = 0.55, 95%CI: 0.17 to 0.93), cluster of differentiation 4 (CD4+) (SMD = -1.38, 95%CI: -2.33 to -0.43) and a reduced lymphocytes ratio (SMD = -0.48, 95%CI: -0.93 to -0.33)) compared with patients with mild illness. The risk factors for death included cyanosis (OR = 5.82, 95% CI: 2.29 to 14.81), a fast heart rate (OR = 3.22, 95% CI: 1.65 to 6.30), vomiting (OR = 2.70, 95% CI: 1.33 to 5.49) and an increased WBC count (SMD = 0.60, 95% CI: 0.27 to 0.93).
China has the highest incidence of HFMD. Our meta-analyses revealed important risk factors that are associated with the severity and mortality of HFMD.
在过去的几年中，仅开发了几种单价 EV71 疫苗，而其他肠道病毒疫苗则供应不足。我们进行了一项定量荟萃分析，以探讨手足口病（HFMD）的流行病学特征、常规实验室诊断、临床症状和危险因素。
检索了 2021 年 4 月 16 日之前发表的符合条件的报告，包括 PubMed、Embase 和 Web of Science，没有发表时间或语言限制。主要结局是与 HFMD 严重程度和死亡相关的流行病学特征、常规实验室诊断和临床症状的优势比。
经过筛选 10522 条记录，我们纳入了 32 篇文章，共包含 781903 例手足口病。重症患者出现一些临床症状（嗜睡（OR=21.97，95%CI：4.13 至 116.74）、抽搐（OR=16.18，95%CI：5.30 至 49.39）、肢体震颤（OR=47.96，95%CI：15.17 至 151.67）和呼吸困难（OR=7.48，95%CI：1.90 至 29.40））和一些实验室参数的变化（白细胞介素-6 水平标准化均数差（SMD）=1.57，95%CI：0.55 至 2.60）、中性粒细胞比例升高（SMD=0.55，95%CI：0.17 至 0.93）、CD4+（SMD=-1.38，95%CI：-2.33 至 -0.43）和淋巴细胞比例降低（SMD=-0.48，95%CI：-0.93 至 -0.33））与轻症患者相比。死亡的危险因素包括发绀（OR=5.82，95%CI：2.29 至 14.81）、心率加快（OR=3.22，95%CI：1.65 至 6.30）、呕吐（OR=2.70，95%CI：1.33 至 5.49）和白细胞计数增加（SMD=0.60，95%CI：0.27 至 0.93）。
中国手足口病发病率最高。我们的荟萃分析揭示了与手足口病严重程度和死亡率相关的重要危险因素。
