In:
PLOS Global Public Health, Public Library of Science (PLoS), Vol. 3, No. 2 ( 2023-2-23), p. e0001553-
Kurzfassung:
Pneumonia is a leading cause of child mortality. However, currently we lack simple, objective, and accurate risk-stratification tools for pediatric pneumonia. Here we test the hypothesis that measuring biomarkers of immune and endothelial activation in children with pneumonia may facilitate the identification of those at risk of death. We recruited children 〈 10 years old fulfilling WHO criteria for pneumonia and admitted to the Manhiça District Hospital (Mozambique) from 2010 to 2014. We measured plasma levels of IL-6, IL-8, Angpt-2, sTREM-1, sFlt-1, sTNFR1, PCT, and CRP at admission, and assessed their prognostic accuracy for in-hospital, 28-day, and 90-day mortality. Healthy community controls, within same age strata and location, were also assessed. All biomarkers were significantly elevated in 472 pneumonia cases versus 80 controls (p 〈 0.001). IL-8, sFlt-1, and sTREM-1 were associated with in-hospital mortality (p 〈 0.001) and showed the best discrimination with AUROCs of 0.877 (95% CI: 0.782 to 0.972), 0.832 (95% CI: 0.729 to 0.935) and 0.822 (95% CI: 0.735 to 0.908), respectively. Their performance was superior to CRP, PCT, oxygen saturation, and clinical severity scores. IL-8, sFlt-1, and sTREM-1 remained good predictors of 28-day and 90-day mortality. These findings suggest that measuring IL-8, sFlt-1, or sTREM-1 at hospital presentation can guide risk-stratification of children with pneumonia, which could enable prioritized care to improve survival and resource allocation.
Materialart:
Online-Ressource
ISSN:
2767-3375
DOI:
10.1371/journal.pgph.0001553
DOI:
10.1371/journal.pgph.0001553.g001
DOI:
10.1371/journal.pgph.0001553.g002
DOI:
10.1371/journal.pgph.0001553.t001
DOI:
10.1371/journal.pgph.0001553.t002
DOI:
10.1371/journal.pgph.0001553.t003
DOI:
10.1371/journal.pgph.0001553.t004
DOI:
10.1371/journal.pgph.0001553.s001
DOI:
10.1371/journal.pgph.0001553.s002
DOI:
10.1371/journal.pgph.0001553.s003
DOI:
10.1371/journal.pgph.0001553.s004
DOI:
10.1371/journal.pgph.0001553.s005
DOI:
10.1371/journal.pgph.0001553.s006
DOI:
10.1371/journal.pgph.0001553.s007
DOI:
10.1371/journal.pgph.0001553.s008
Sprache:
Englisch
Verlag:
Public Library of Science (PLoS)
Publikationsdatum:
2023
ZDB Id:
3101394-6
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