Neonates with enterovirus infection: retrospective study on clinical characteristics of 81 case and prognostic scoring system

Objective To study the clinical features of neonates with enteroviral infection. Method We collected all neonates with enteroviral infection confirmed pathologically in the Department of Neonatology in the Children's Hospital of Fudan University from March 2009 to July 2016 retrospectively. The clinical data of the patients (clinical manifestation, first laboratory examinations, imaging findings, treatment procedures and outcomes) were retrieved to summarize the clinical features of neonatal enterovirus infection and to analyze the factors affecting the prognosis of neonatal enterovirus infection. Result A total of 81 neonates with enterovirus infection were included in the study. Among them, 55 were full-term infants and 26 were premature infants, and the birth weight was (3 029±728)g. The median age of hospital admission was 5 (1,16) d, and multiple systemic manifestations were common in the course of the disease. Among them, 19.8% (16/81) died. The factors for death are preterm birth, decreased hemoglobin, platelet count or serum albumin levels, abnormal coagulation, elevated blood lactate levels and acidosis. A scoring system was established based on high-risk factors. A score of ≥ 4 could reliably predict adverse outcomes, with a specificity of 92.3% and a sensitivity of 93.8%. Conclusion Enteroviral infection in neonates can be highlt critical multiple system involvement. Neonates enterovirus infections with high risk factors(premature delivery, hemoglobin/ platelet/ albumin hypoplasia, coagulation dysfunction, lactic acid increase and acidosis) had higher mortality rate. There is a need to identify these neonates for intensive care and better treatment is warranted to improve the prognosis of these patients early. Key words: Enterovirus infections; Prognosis; Clinical manifestation; Infant, newborn