Abstract
Objective To find risk markers and develop new clinical predictive models for the differential diagnosis of hand-foot-and-mouth disease (HFMD) with varying degrees of disease. Methods 19766 children with HFMD and 64 clinical indexes were included in this study. The patients included in this study were divided into the mild patients' group (mild) with 12292 cases, severe patients' group (severe) with 6508 cases, and severe patients with respiratory failure group (severe-RF) with 966 cases. Single-factor analysis was carried out on 64 indexes collected from patients when they were admitted to the hospital, and the indexes with statistical differences were selected as the prediction factors. Binary multivariate logistic regression analysis was used to construct the prediction models and calculate the adjusted odds ratio (OR). Results SP, DP, NEUT#, NEUT%, RDW-SD, RDW-CV, GGT, CK/CK-MB, and Glu were risk markers in mild/severe, mild/severe-RF, and severe/severe-RF. Glu was a diagnostic marker for mild/severe-RF (AUROC = 0.80, 95% CI: 0.78-0.82); the predictive model constructed by temperature, SP, MOMO%, EO%, RDW-SD, GLB, CRP, Glu, BUN, and Cl could be used for the differential diagnosis of mild/severe (AUROC > 0.84); the predictive model constructed by SP, age, NEUT#, PCT, TBIL, GGT, Mb, β2MG, Glu, and Ca could be used for the differential diagnosis of severe/severe-RF (AUROC > 0.76). Conclusion By analyzing clinical indicators, we have found the risk markers of HFMD and established suitable predictive models.
Highlights
Hand-foot-and-mouth disease (HFMD) is a common viral illness mainly caused by enterovirus 71 (EV71) and coxsackie A16 (CA16), which mainly affects children under 5 years of age [1, 2]
Through the statistical analysis of all the indicators included in the study, we found that 52, 44, and 51 indicators showed statistical differences between mild/severe, severe/severe-RF, and mild/severe-RF, respectively, and 30 indicators showed significant differences among the three groups (Table 2)
Calculating the adjusted odds ratio (OR) values between the mild/severe, mild/severe-RF, and severe/severe-RF groups, we found that a total of 19 indicators may be risk factors of mild development to severe, where temperature and Glu performed better (Figure 1(a))
Summary
Hand-foot-and-mouth disease (HFMD) is a common viral illness mainly caused by enterovirus 71 (EV71) and coxsackie A16 (CA16), which mainly affects children under 5 years of age [1, 2]. Most patients with HFMD have mild symptoms and can be cured in 7-10 days. It is important to develop a clinical decision-making tool to predict and early identify HFMD patients with different degrees of disease to provide effective interventions. Many previous studies have focused on investigating the risk markers and exploring prediction models of HFMD [7,8,9,10], there are still few studies to find the risk factors of HFMD patients and establish a prediction model by using only various laboratory test indicators. Retrospective case-control analysis was used to explore the risk factors of early recognition of progression from mild to severe and from common severe to severe-RF by analyzing various types of blood test indicators of HFMD patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
