A predicted capsid model of EV-D68 prepared by CYTW. Models was prepared using computer programs, DeepView/Swiss-Pdb Viewer v4.1.0 and UCSF Chimera v1.7. Sequences for each capsid peptide were threade...

The latest on the mysterious illness causing widespread respiratory symptoms, fatigue, and muscle pain across the US. Learn how to identify the illness, its effects, and how to treat it effectively, w...

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Enterovirus D68, which in rare cases can cause polio-like paralysis in children, is on the rise in California and across the nation, analyses show.

TikTok video by LaughterinLight PhD

Dear Editor, the publication on “Clinical Insights and Severity of Enterovirus D68 Respiratory Infections in Vietnamese Children [1]” is hereby discussed. This study is valuable in describing the clinical features and risk of severe respiratory disease in children infected with Enterovirus D68 compared with rhinovirus and other enteroviruses. However, the research methodology has limitations that should be considered. Firstly, the study uses data from a single national surveillance system, Vietnam, which may limit the ability to apply the results in the context of populations in other regions with different epidemic patterns, demographic structures, and healthcare systems. Furthermore, despite a sample size of 1100 patients, only 55 patients had confirmed EVD68 infection, which may limit the statistical power of some comparisons, especially when subcategories are based on comorbidities and asthma.

Enterovirus D68 (EVD68) causes respiratory disease, yet the risk of severe respiratory disease remains incompletely quantified, especially when stratified by comorbidity status. This study aims to describe the clinical features and risk of severe disease in children with EVD68 compared with those with other Rhinoviruses/Enteroviruses, accounting for comorbidity.MethodsWe analyzed 1100 pediatric EV-positive cases from surveillance in Vietnam (2019–2022), excluding viral coinfections. EVD68 was confirmed by real-time PCR. We examined clinical features, treatments, and comorbidities. Standardization methods estimated risk differences (RDs) and risk ratios (RRs) stratified by (1) general comorbidity, (2) asthma, and (3) either of these. Time-to-recovery in intensive care unit (ICU) was compared using Kaplan–Meier methods.ResultsEVD68 was detected in 55/1100 cases (5.0%). Children with EVD68 more often had wheeze, pneumonia, oxygen therapy, and ICU admission. For wheeze, EVD68 was associated with similar elevated risk with and without general comorbidity (RR 1.40 in both; RD 0.27). Pneumonia risk was likewise elevated with EVD68 (with comorbidity: RR 1.17; RD 0.12; without: RR 1.73; RD 0.14). By asthma status, EVD68 increased wheeze risk in both groups; however, the excess was smaller in asthma (RR 1.10; RD 0.09) than non-asthma (RR 1.43; RD 0.29), consistent with baseline wheeze susceptibility in asthma. Pneumonia risk was similar regardless of asthma status. During ICU stay, wheeze persisted longest in both groups. Time-to-recovery was similar between groups.ConclusionsEVD68 infection was associated with a higher risk of severe disease than Rhinoviruses/Enteroviruses, independent of documented comorbidity, indicating substantial risk even among previously healthy children.

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