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Volume 26, Number 2—February 2020
Research

Neutralizing Antibodies against Enteroviruses in Patients with Hand, Foot and Mouth Disease

Lam Anh NguyetComments to Author , Tran Tan Thanh, Le Nguyen Thanh Nhan, Nguyen Thi Thu Hong, Le Nguyen Truc Nhu, Hoang Minh Tu Van, Nguyen Thi Han Ny, Nguyen To Anh, Do Duong Kim Han, Ha Manh Tuan, Vu Quang Huy, Ho Lu Viet, Hoang Quoc Cuong, Nguyen Thi Thanh Thao, Do Chau Viet, Truong Huu Khanh, Louise Thwaites, Hannah Clapham, Nguyen Thanh Hung, Nguyen Van Vinh Chau, Guy Thwaites, Do Quang Ha, H. Rogier van Doorn, and Le Van TanComments to Author 
Author affiliations: Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam (L.A. Nguyet, T.T. Thanh, N.T.T. Hong, L.N.T. Nhu, H.M.T. Van, N.T.H. Ny, N.T. Anh, D.D.K. Han, L. Thwaites, H. Clapham, G. Thwaites, D.Q. Ha, H.R. van Doorn, L.V. Tan); Children’s Hospital 1, Ho Chi Minh City (L.N.T. Nhan, T.H. Khanh, N.T. Hung); Children’s Hospital 2, Ho Chi Minh City (H.M. Tuan, H.L. Viet, D.C. Viet); University of Medicine and Pharmacy, Ho Chi Minh City (H.M. Tuan, V.Q. Huy); Pasteur Institute, Ho Chi Minh City (H.Q. Cuong, N.T.T. Thao); University of Oxford, Oxford, UK (L. Thwaites, H. Clapham, G. Thwaites, H.R. van Doorn); Hospital for Tropical Diseases, Ho Chi Minh City (N.V.V. Chau)

Main Article

Table 1

Baseline characteristics and clinical outcome of the patients included in study of patients with hand, foot and mouth disease, Vietnam*

Characteristics All, N = 120 EV-A71, N = 30 CVA6, N = 30 CVA10, N = 30 CVA16, N = 30 p value†
Demographics
Sex ratio, F/M 45/75 8/22 8/22 14/16 15/15 0.12
Median age, mo (range)
 16.2 (1.8–59)
 16.7 (4.9–58.6)
 16.4 (5.3–59)
 14.7 (1.8–41.4)
 19 (5.8–46.5)
 0.11
Median day of illness from onset (range)
To hospital admission 1 (0–5) 2 (0–4) 1 (0–3) 1 (0–3) 1 (0–5) 0.058
To enrollment in study 2 (0–6) 2 (0–4) 1.5 (0–3) 2 (0–6) 2 (0–6) 0.802
To collection of second plasma
 9 (7–17)
 9 (7–12)
 9 (7–14)
 9 (7–14)
 9 (8–17)
 0.211
Median day of hospitalization‡
 3 (1–12)
 4 (2–10)
 3 (1–8)
 3 (1–6)
 4 (2–12)
 0.3
Inpatient/outpatient ratio
 77/43
 17/13
 18/12
 25/5
 17/13
 0.08
Clinical characteristics, no. (%)
Fever 87 (72.5) 24 (80) 17 (56.7) 24 (80) 17 (56.7) 0.16
Cough 26 (21.7) 6 (20) 2 (6.7) 8 (26.7) 10 (33.3) 0.06
Runny nose 21 (17.5) 6 (20) 3 (10) 5 (16.7) 7 (23.3) 0.63
Vomiting 25 (20.8) 7 (23.3) 5 (16.7) 5 (16.7) 8 (26.7) 0.77
Diarrhea 14 (11.7) 3 (10) 3 (10) 3 (10) 5 (16.7) 0.89
Drowsiness 6 (5) 2 (6.7) 0 2 (6.7) 2 (6.7) 0.6
Irritability 14 (11.7) 5 (16.7) 2 (6.7) 5 (16.7) 2 (6.7) 0.46
Myoclonus 30 (25) 10 (33.3) 3 (10) 9 (30) 8 (27) 0.13
Sweating 4 (3.3) 1 (3.3) 1 (3.3) 1 (3.3) 1 (3.3) 1
Lethargy 2 (1.7) 0 0 2 (6.7) 0 0.24
Conjunctivitis 1 (0.8) 0 1 (3.3) 0 0 1
Rash 106 (88.3) 30 (100) 30 (100) 17 (56.7) 19 (63.3) 0
Mouth lesion 111 (92.5) 28 (93.3) 23 (76.7) 30 (100) 30 (100) 0.001
Limb weakness
 4 (3.3)
 1 (3.3)
 1 (3.3)
 1 (3.3)
 1 (3.3)
 0.80
Median pulse, bpm (range)
 120 (96–180)
 120 (96–180)
 120 (100–167)
 125 (100–165)
 120 (100–170)
 0.632
Median blood pressure, mm Hg (range)
Systolic 90 (75–128) 90 (75–100) 90 (80–120) 90 (80–120) 90 (80–128) 0.661
Diastolic
 60 (40–80)
 55 (50–62)
 55 (40–80)
 60 (50–80)
 60 (50–77)
 0.551
Blood biochemistry results, median (range)
Leukocyte count, × 109 cells/L 13.1 (1–50.6) 13.6 (7.8–50.6) 12.5 (1–25.9) 14.3 (5–24.7) 12.4 (4.5–24.4) 0.638
Neutrophils, % 51
(2.1–92.7) 51.2
(19.7–72.8) 52.7
(7.7–92.7) 47.6
(2.1–76.3) 50.9
(24.2–86.1) 0.658
Lymphocytes, % 37.1
(3.7–80.2) 37.1
(18.4–65.5) 33.9
(3.7–80.2) 37.6
(17.6–71.2) 36.5
(6.1–60.3) 0.846
Platelet count, × 109/L 322.5
(96–597) 360
(189–522) 341.5
(150–513) 297
(96–452) 293.5
(175–597) 0.086
Glucose, mg/dL 107 (0–212) 112 (62–170) 108.5 (0–154) 108.5 (68–212) 98.5 (51–164) 0.324
C-reactive protein, mg/dL
 12.4 (0–102)
 4.1 (0–100)
 13.7 (0–102)
 23.3 (3–58)
 9.9 (0–39)
 <0.001
Clinical grade, no. (%)
Mild 107 (89.2) 24 (80) 29 (96.7) 28 (93.3) 26 (86.7) 0.2
Severe
 13 (10.8)
 6 (20)
 1 (3.3)
 2 (6.7)
 4 (13.3)
IVIg administration, no. (%)
 8 (6.7%)
 3 (10)
 1 (3.3)
 1 (3.3)
 3 (10)
 0.5
Outcome, no. (%)
Full recovery 119 (99.2) 30 (100) 29 (96.7) 30 (100) 30 (100) 0.17
Incomplete recovery 1 (0.8) 0 1 (3.3) 0 0

*CV, coxsackievirus; EV, enterovirus; IVIg, intravenous immunoglobulin.
†Results of statistical analyses comparing individual groups of patients infected with EV-A71, CVA6, CVA10, or CVA16.
‡Inpatients only.

Main Article

Page created: January 17, 2020
Page updated: January 17, 2020
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