Analysis of Clinical Characteristics and the Effect of Symptomatic Supportive Treatment for Severe Neonatal Enterovirus Infection

Zhe Xuan,1 Ting Wang,1 Ning Li,1 Ziqian Tang2 1Department of Neonatology, Zhuzhou Central Hospital, Zhuzhou, Hunan, 412000, People’s Republic of China; 2Department of Obstetrics and Gynecology, Zhuzhou Central Hospital, Zhuzhou, Hunan, 412000, People’s Republic of ChinaCorrespondence: Ziqian Tang, Email [email protected]: To retrospectively analyze cases of neonatal enterovirus (EV) infection, identify risk factors for severe infection, pathological characteristics, and prognostic differences, and provide a basis for early identification of high-risk neonates.Methods: Neonates diagnosed with EV infection and admitted to Zhuzhou Central Hospital between January 2020 and December 2023 were included in the study. Based on disease severity, they were divided into a mild infection group (n = 149) and a severe infection group (n = 44). Data on demographic characteristics, clinical manifestations, laboratory findings, treatment methods, and prognosis were collected and statistically analyzed using SPSS 26.0.Results: Compared to the mild infection group, the severe infection group had lower gestational age (36.61 vs 38.50 weeks, P < 0.001) and higher preterm birth rates (P < 0.05). They presented earlier with higher incidences of rash, respiratory symptoms, and sepsis-like signs (all P < 0.05). Severe cases had significantly higher rates of pneumonia, myocarditis, necrotizing hepatitis, and DIC (all P < 0.001), with a mortality rate of 54.55% (P < 0.001). Laboratory findings showed more thrombocytopenia, coagulation dysfunction, and organ injury markers in the severe group (all P < 0.001). Mild cases required mainly non-invasive treatment, while severe cases had high mortality despite intensive interventions. Among survivors, 50% required long-term neurological rehabilitation.Conclusion: Severe neonatal EV infection is closely associated with preterm birth and perinatal infection, characterized by thrombocytopenia, coagulation dysfunction, and multiple organ damage. Early monitoring of high-risk neonates, especially preterm infants, should be reinforced. For neonates presenting within the first seven days of life with rash or respiratory distress accompanied by a rapid decline in platelet count, intensive care should be promptly initiated. Further research is needed to explore targeted antiviral therapies and immune modulation strategies.Keywords: neonate, enterovirus, severe infection, symptomatic supportive treatment, retrospective study