Huili Hu, Huiling Deng, Jing Bi, Yi Xu, Shuangjie Li, Yue Xie, Xinrong Sun, Dongmeng Wang, Xufang Li, Wenxian Ouyang, Bing Hu, Yufeng Zhang, He Tang, Chunxiao Fang, Hui Zhang, Lingyun Guo, Chen Wang, Tianyi Wang, Fengxia Yang, Tao Jiang, Zhengde Xie, Gang Liu
{"title":"中国感染性单核细胞增多症住院患儿的临床特征和抗病毒药物的有效性：多中心回顾性研究。","authors":"Huili Hu, Huiling Deng, Jing Bi, Yi Xu, Shuangjie Li, Yue Xie, Xinrong Sun, Dongmeng Wang, Xufang Li, Wenxian Ouyang, Bing Hu, Yufeng Zhang, He Tang, Chunxiao Fang, Hui Zhang, Lingyun Guo, Chen Wang, Tianyi Wang, Fengxia Yang, Tao Jiang, Zhengde Xie, Gang Liu","doi":"10.1002/ped4.12294","DOIUrl":null,"url":null,"abstract":"<p><strong>Importance: </strong>The clinical characteristics of infectious mononucleosis (IM) in Chinese children have not been evaluated in multicenter studies, and the effectiveness of antiviral treatment are controversial.</p><p><strong>Objective: </strong>To investigate the clinical characteristics of Chinese children with IM and current status of antiviral therapy for affected patients.</p><p><strong>Methods: </strong>Hospitalized patients with IM were enrolled between 2018 and 2020 in five children's hospitals in China. The clinical characteristics were compared among four age groups: <3 years, 3-<6 years, 6-<10 years, and ≥10 years. The clinical characteristics of IM and effectiveness of antiviral therapy were compared among patients receiving acyclovir (ACV), ganciclovir (GCV), and no antiviral therapy (i.e., non-antiviral group).</p><p><strong>Results: </strong>In total, 499 patients were analyzed; most patients were 3-<6 years of age. The most common symptoms and signs included fever (100%), lymphadenopathy (98.6%), pharyngitis (86.4%), eyelid edema (76.8%), and snoring (72.9%). There were significant differences in rash, hepatomegaly, and liver dysfunction among the four age groups. Patients aged < 3 years had a lower incidence of liver dysfunction and a higher incidence of rash. Among the 499 patients, 50.1% were treated with GCV, 26.3% were treated with ACV, and 23.6% received no antiviral therapy. Compared with the non-antiviral group, patients in the ACV and GCV groups had longer durations of fever (<i>P <</i> 0.001). There were no significant differences in the incidences of complications among the three treatment groups.</p><p><strong>Interpretation: </strong>The incidence of IM in Chinese children peaked at 3-<6 years of age. Clinical features of IM varied according to age. Patients receiving antiviral therapy exhibited more serious clinical manifestations than did patients without antiviral therapy. 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The clinical characteristics were compared among four age groups: <3 years, 3-<6 years, 6-<10 years, and ≥10 years. The clinical characteristics of IM and effectiveness of antiviral therapy were compared among patients receiving acyclovir (ACV), ganciclovir (GCV), and no antiviral therapy (i.e., non-antiviral group).</p><p><strong>Results: </strong>In total, 499 patients were analyzed; most patients were 3-<6 years of age. The most common symptoms and signs included fever (100%), lymphadenopathy (98.6%), pharyngitis (86.4%), eyelid edema (76.8%), and snoring (72.9%). There were significant differences in rash, hepatomegaly, and liver dysfunction among the four age groups. Patients aged < 3 years had a lower incidence of liver dysfunction and a higher incidence of rash. Among the 499 patients, 50.1% were treated with GCV, 26.3% were treated with ACV, and 23.6% received no antiviral therapy. Compared with the non-antiviral group, patients in the ACV and GCV groups had longer durations of fever (<i>P <</i> 0.001). There were no significant differences in the incidences of complications among the three treatment groups.</p><p><strong>Interpretation: </strong>The incidence of IM in Chinese children peaked at 3-<6 years of age. Clinical features of IM varied according to age. Patients receiving antiviral therapy exhibited more serious clinical manifestations than did patients without antiviral therapy. 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引用次数: 0
摘要
重要性：中国儿童传染性单核细胞增多症（IM）的临床特征尚未在多中心研究中进行评估，抗病毒治疗的有效性也存在争议：调查中国儿童传染性单核细胞增多症患者的临床特征以及对患者进行抗病毒治疗的现状。方法：在2018年至2020年间，在中国的5家儿童医院招募住院的传染性单核细胞增多症患者。比较四个年龄组的临床特征：结果共对 499 例患者进行了分析；大多数患者为 3-P 0.001）。三个治疗组的并发症发生率无明显差异：解释：中国儿童 IM 的发病率在 3- 6 岁达到高峰。
Clinical characteristics and effectiveness of antiviral agents in hospitalized children with infectious mononucleosis in China: A multicenter retrospective study.
Importance: The clinical characteristics of infectious mononucleosis (IM) in Chinese children have not been evaluated in multicenter studies, and the effectiveness of antiviral treatment are controversial.
Objective: To investigate the clinical characteristics of Chinese children with IM and current status of antiviral therapy for affected patients.
Methods: Hospitalized patients with IM were enrolled between 2018 and 2020 in five children's hospitals in China. The clinical characteristics were compared among four age groups: <3 years, 3-<6 years, 6-<10 years, and ≥10 years. The clinical characteristics of IM and effectiveness of antiviral therapy were compared among patients receiving acyclovir (ACV), ganciclovir (GCV), and no antiviral therapy (i.e., non-antiviral group).
Results: In total, 499 patients were analyzed; most patients were 3-<6 years of age. The most common symptoms and signs included fever (100%), lymphadenopathy (98.6%), pharyngitis (86.4%), eyelid edema (76.8%), and snoring (72.9%). There were significant differences in rash, hepatomegaly, and liver dysfunction among the four age groups. Patients aged < 3 years had a lower incidence of liver dysfunction and a higher incidence of rash. Among the 499 patients, 50.1% were treated with GCV, 26.3% were treated with ACV, and 23.6% received no antiviral therapy. Compared with the non-antiviral group, patients in the ACV and GCV groups had longer durations of fever (P < 0.001). There were no significant differences in the incidences of complications among the three treatment groups.
Interpretation: The incidence of IM in Chinese children peaked at 3-<6 years of age. Clinical features of IM varied according to age. Patients receiving antiviral therapy exhibited more serious clinical manifestations than did patients without antiviral therapy. The effectiveness of antiviral therapy for IM requires further analysis.
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