Clinical, biological characteristics, risk factors and outcomes in human enterovirus central nervous system infections: a prospective study performed in a tertiary hospital

Human enterovirus (HEV) infection is transmitted mainly by the fecal-oral route and has mostly a subclinical, self -limited evolution.This viral central nervous system (CNS)infection could be fatal in various categories of patients.The aim of the current study was to evaluate the clinicalbiological characteristics and outcomes of HEV CNS infections in patients admitted to the "Sf.Parascheva" Clinical Hospital of Infectious Diseases Iasi, during 2018 -2019.Materials and methods: We performed an observational prospective study in patients with confirmed HEV CNS infections (encephalitis / meningitis) by cerebrospinal fluid analysis.Clinical and laboratory data were collected from medical records.Results: Sixty -four patients were included, of which 57.81% were diagnosed with HEV encephalitis.All categories of ages were affected, with a median of 67 years in encephalitis and 56 years for patients with meningitis.The most frequent comorbidities were cardiovascular (44.29% cases).The blood neutrophillymphocytes ratio (NLR) was statistically significant higher in case of HEV meningitis co mpared to encephalitis (12.42 4.12 vs. 7.97 3.86, p = 0.04).There were significant differences regarding NLR measured in cerebrospinal fluid.The median duration o f hospitalization was 5.63 days in HEV encephalitis and 10.92 days in HEV meningitis.There were re corded 23.33% cases of death, all in old, immunosuppressed patients (diabetic patients) with HEV encephalitis.Conclusions: HEV CNS infections, are an important cause of mortality in high -risk patients (elderly, immunosuppression).Measurement of NLR could be a useful early diagnostic tool to ensure proper pharmacological management of HEV infections.