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Clinical characteristics of severe neonatal enterovirus infection: a systematic review.
Zhang, Meng; Wang, Haoran; Tang, Jun; He, Yang; Xiong, Tao; Li, Wenxing; Qu, Yi; Mu, Dezhi.
Afiliación
  • Zhang M; Department of Pediatrics, West China Second Hospital, Sichuan University, No. 20, Section 3, Renmin south road, Chengdu, 610041, China.
  • Wang H; Key Laboratory of Obstetrics & Gynecologic and Pediatric Diseases and Birth Defects of the Ministry of Education, Sichuan University, Chengdu, 610041, China.
  • Tang J; Department of Clinical Medicine, Sichuan University, Chengdu, 610041, China.
  • He Y; Department of Pediatrics, West China Second Hospital, Sichuan University, No. 20, Section 3, Renmin south road, Chengdu, 610041, China. tj1234753@sina.com.
  • Xiong T; Key Laboratory of Obstetrics & Gynecologic and Pediatric Diseases and Birth Defects of the Ministry of Education, Sichuan University, Chengdu, 610041, China. tj1234753@sina.com.
  • Li W; Department of Pediatrics, West China Second Hospital, Sichuan University, No. 20, Section 3, Renmin south road, Chengdu, 610041, China.
  • Qu Y; Key Laboratory of Obstetrics & Gynecologic and Pediatric Diseases and Birth Defects of the Ministry of Education, Sichuan University, Chengdu, 610041, China.
  • Mu D; Department of Pediatrics, West China Second Hospital, Sichuan University, No. 20, Section 3, Renmin south road, Chengdu, 610041, China.
BMC Pediatr ; 21(1): 127, 2021 03 15.
Article en En | MEDLINE | ID: mdl-33722228
ABSTRACT

BACKGROUND:

Enterovirus (EV) is a common cause of infection in neonates. Neonates are at high risk of enterovirus infection with serious clinical manifestations and high lethality. This review systematically summarized the clinical characteristics of neonates with severe enteroviral infection to provide evidence for the identification and treatment of severe neonatal EV infection.

METHODS:

PubMed, Embase, and Web of Science were searched for original studies on neonates with severe EV infections from January 1, 2000, to November 27, 2020. Two reviewers independently screened the literature, extracted the data, and performed a descriptive analysis.

RESULTS:

In total, 66 articles with 237 cases of severe neonatal enterovirus infection were included. All neonates developed severe complications. Among them, 46.0% neonates had hepatitis or coagulopathy, 37.1% had myocarditis, 11.0% had meningoencephalitis, and 5.9% had other complications such as hemophagocytic lymphohistiocytosis and pulmonary hemorrhage. The lethality rate of neonates with severe infection was 30.4%. The highest lethality rate was 38.6%, which was observed in neonates with myocarditis. In 70.5% neonates, the age at the onset of symptoms was less than 7 days. Coxsackievirus B infection was seen in 52.3% neonates. The most common symptoms included temperature abnormalities (127, 53.6%), rash (88, 37.1%), poor feeding (58, 24.5%), and respiratory symptoms (52, 21.9%). The main treatment included transfusion of empirical antibiotics (127, 53.6%), blood components (100, 42.2%), intravenous immunoglobulin (IVIG; 97, 40.9%), mechanical ventilation (51, 21.5%), and extracorporeal membrane oxygenation (ECMO; 43, 18.1%). Additionally, antiviral medications pleconaril (14, 5.9%) and pocapavir (3, 1.3%) were administered.

CONCLUSIONS:

Lethality was high in neonates with severe enterovirus infection, especially in those complicated with myocarditis. The most common symptoms included temperature abnormalities, rash, and poor feeding. The chief supportive treatment consisted of transfusion of blood components, mechanical ventilation, and ECMO. Empirical antibiotics and IVIG were widely used. Antiviral medications included pocapavir and pleconaril; however, more clinical evidence regarding their efficacy is needed.
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Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Oxigenación por Membrana Extracorpórea / Enfermedades Transmisibles / Enterovirus / Infecciones por Enterovirus / Miocarditis Tipo de estudio: Diagnostic_studies / Prognostic_studies / Systematic_reviews Límite: Humans / Newborn Idioma: En Revista: BMC Pediatr Asunto de la revista: PEDIATRIA Año: 2021 Tipo del documento: Article País de afiliación: China

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Oxigenación por Membrana Extracorpórea / Enfermedades Transmisibles / Enterovirus / Infecciones por Enterovirus / Miocarditis Tipo de estudio: Diagnostic_studies / Prognostic_studies / Systematic_reviews Límite: Humans / Newborn Idioma: En Revista: BMC Pediatr Asunto de la revista: PEDIATRIA Año: 2021 Tipo del documento: Article País de afiliación: China