Serum inflammatory cytokines IL-1, IL-6, and TNF-α as biomarkers for predicting the severity of pediatric hand-foot-mouth disease: A retrospective cohort study

This study aimed to explore the association between inflammatory cytokines and the severity of pediatric hand-foot-mouth disease (HFMD) and identify predictive biomarkers. We conducted a retrospective analysis of 240 children, including 120 severe HFMD cases and 120 mild HFMD cases admitted to the Linping Campus of The Second Affiliated Hospital of Zhejiang University. Comprehensive clinical data, including demographic information, clinical manifestations, and laboratory parameters, were collected upon hospital admission. Serum concentrations of interleukin-1 (IL-1), IL-6, and tumor necrosis factor-alpha (TNF-α) were quantified using enzyme-linked immunosorbent assays at days 1, 3, and 5 postadmission. Multivariate logistic regression was used to identify significant risk factors. Compared with the mild group, the severe group had a younger age (16.8 ± 10.5 vs 22.2 ± 12.2 months) and longer fever duration and hospital stay (all P  = .001). Key laboratory indices (e.g., white blood cell count, blood glucose) were higher in severe cases ( P  < .001). IL-1, IL-6, and TNF-α levels in the severe group were significantly elevated at all-time points ( P  < .05), with receiver operating characteristic area under the curves of 0.87, 0.81, and 0.72, respectively. Age, fever duration, blood glucose, IL-1, IL-6, and TNF-α were identified as independent risk factors (all P  = .001). IL-1, IL-6, and TNF-α are valuable biomarkers for predicting pediatric HFMD severity, with IL-1 showing the highest predictive efficacy, providing a basis for early clinical intervention.