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Review
. 2022 Oct 29;10(11):1829.
doi: 10.3390/vaccines10111829.

Laboratory Indicators for Identifying Hand, Foot, and Mouth Disease Severity: A Systematic Review and Meta-Analysis

Yaqi Xie  1 , Quanman Hu  1 , Wenjie Jiang  1 , Wangquan Ji  1 , Shuaiyin Chen  1 , Yuefei Jin  1 , Guangcai Duan  1   2
Affiliations
Review

Laboratory Indicators for Identifying Hand, Foot, and Mouth Disease Severity: A Systematic Review and Meta-Analysis

Yaqi Xie et al. Vaccines (Basel). .

Abstract

Objective: The purpose of this study is to study laboratory indicators for the identification of hand, foot, and mouth disease (HFMD) severity.

Methods: We searched PubMed, Embase, and the Web of Science for literature that was published before May 2022. The main results are presented as forest plots. Subgroup analyses, sensitivity analyses, and publication bias were also performed.

Results: Our study indicated that white blood cells (WBC) (95%CI: 0.205-0.778), blood glucose (95%CI: 0.505-0.778), lymphocytes (95%CI: 0.072-0.239), creatinine (95%CI: 0.024-0.228), interleukin (IL)-2 (95%CI: 0.192-1.642), IL-6 (95%CI: 0.289-0.776), IL-8 (95%CI: 0.499-0.867), IL-10 (95%CI: 0.226-0.930), interferon-γ (IFN-γ) (95%CI: 0.193-2.584), tumor necrosis factor-α (TNF-α) (95%CI: 1.078-2.715), and creatine kinase MB isoenzyme (CK-MB) (95%CI: 0.571-1.459) were associated with an increased risk of HFMD severity, and the results of the sensitivity analysis of these indicators were stable and free of publication bias.

Conclusions: Our results suggest that various deleterious immune and metabolic changes can increase the risk of HFMD severity, which can provide a basis for predicting the prognosis and useful evidence for clinicians to manage patients efficiently.

Keywords: hand, foot and mouth disease; laboratory indicators; meta-analysis; severity; systematic review.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of the study selection process.
Figure 2
Figure 2
Forest plot for the association of cytokines with HFMD severity (a): IL-2; (b): IL-10; (c): IL-6; (d): IL-8; (e): IFN-γ; (f): TNF-α. (* [24]).
Figure 3
Figure 3
Forest plot for the association of blood indicators with HFMD severity (a): WBC; (b): blood glucose; (c): lymphocytes; (d): creatinine; (e): CK-MB. (* [24]).
Figure 4
Figure 4
Begg’s funnel plot of laboratory indicators. The main results of the p-values of Begg’s test are listed in Table 2 (a): IL-2; (b): IL-10; (c): IL-6 (d): IL-8 (e): IFN-γ; (f): TNF-α.
Figure 5
Figure 5
Begg’s funnel plot of laboratory indicators (a): WBC; (b): blood glucose; (c): lymphocytes; (d): creatinine; (e): CK-MB.
Figure 6
Figure 6
Sensitivity analysis of laboratory indicators (a): IL-2; (b): IL-10; (c): IL-6; (d): IL-8; (e): IFN-γ; (f): TNF-α. (* [24]).
Figure 7
Figure 7
Sensitivity analysis of laboratory indicators (a): WBC; (b): blood glucose; (c): lymphocytes; (d): creatinine; (e): CK-MB. (* [24]).
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