The following is a summary of “Coinfection of viruses in children with community-acquired pneumonia,” published in the July 2024 issue of Pediatrics by Mao et al.
Respiratory tract viral infections are commonly associated with community-acquired pneumonia (CAP) in children, and co-infection with multiple viruses is likely to occur. Despite the high prevalence of viral co-infection in CAP cases, studies exploring the impact of such co-infections on clinical and laboratory indices are limited. This study investigated the relationships between co-infection with seven common viruses and various clinical and laboratory parameters in children with CAP.
A retrospective analysis involved 684 pediatric patients with CAP admitted to the hospital. The study focused on seven common viruses: influenza A (FluA), influenza B (FluB), human parainfluenza virus (HPIV), Epstein-Barr virus (EBV), coxsackie virus (CoxsV), cytomegalovirus (CMV), and herpes simplex virus (HSV). Researchers evaluated the association of these viruses with clinical outcomes and laboratory indices, including hospitalization duration, white blood cell count (WBC), C-reactive protein (CRP), platelet count (PLT), erythrocyte sedimentation rate (ESR), procalcitonin (PCT), urine red blood cell count (uRBC), blood urea nitrogen (BUN), serum creatinine (Scr), alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), creatine kinase (CK), and creatine kinase isoenzyme (CKMB). One-way ANOVA was used to compare these parameters among different virus co-infection groups. Independent samples t-tests assessed differences between ordinary and severe pneumonia cases and between single versus multiple virus infections. Receiver operating characteristic (ROC) curve analyses evaluated the predictive value of clinical and laboratory parameters for viral co-infection risk, and binary logistic regression analyzed the associations between various indices and virus co-infection.
Among the 684 cases, 84 exhibited multiple viral co-infections, compared to 220 cases with single viral infections. CMV co-infection was associated with the longest hospitalization duration and the highest ALT, AST, and CKMB levels. HSV co-infection correlated with elevated WBC count, CRP, ESR, and BUN. EBV co-infection was linked to increased PLT and PCT levels, while FluB co-infection was associated with the highest Scr levels. CoxsV co-infection resulted in elevated uRBC, LDH, and CK levels. ROC curve analysis revealed that CK had the highest area under the curve (AUC: 0.672, p < 10^–4) for predicting viral co-infection risk. Significant associations were observed between PLT, uRBC, BUN, CK, and CKMB levels and CAP’s risk of viral co-infection.
The study highlights that multiple viral co-infections in children with CAP are associated with varying prognoses and impact clinical and laboratory parameters. Different viruses influence the extent of cardiac, liver, renal, and inflammatory injury in CAP. Notably, changes in clinical and laboratory parameters, especially CK, may indicate viral co-infection risk in CAP.
Source: bmcpediatr.biomedcentral.com/articles/10.1186/s12887-024-04939-0
