Association of Clinical Signs, Host Biomarkers and Etiology With Radiological Pneumonia in Bhutanese Children
Por:
Jullien S, Richard-Greenblatt M, Casellas A, Tshering K, Ribó JL, Sharma R, Tshering T, Pradhan D, Dema K, Ngai M, Munoz-Almagro C, Kain KC and Bassat Q
Publicada:
1 feb 2022
Resumen:
Diagnosing pneumonia and identifying those requiring antibiotherapy remain challenging. Chest radiographs (CXR) are often used as the reference standard. We aimed to describe clinical characteristics, host-response biomarkers and etiology, and assess their relationship to CXR findings in children with pneumonia in Thimphu, Bhutan. Children between 2 and 59 months hospitalized with WHO-defined pneumonia were prospectively enrolled and classified into radiological endpoint and non-endpoint pneumonia. Blood and nasopharyngeal washing were collected for microbiological analyses and plasma levels of 11 host-response biomarkers were measured. Among 149 children with readable CXR, 39 (26.2%) presented with endpoint pneumonia. Identification of respiratory viruses was common, with no significant differences by radiological outcomes. No clinical sign was suggestive of radiological pneumonia, but children with radiological pneumonia presented higher erythrocyte sedimentation rate, C-reactive protein and procalcitonin. Markers of endothelial and immune activation had little accuracy for the reliable identification of radiological pneumonia.
Filiaciones:
Jullien S:
ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
Richard-Greenblatt M:
Hospital of the University of Pennsylvania, Philadelphia, PA, USA
Children's Hospital of Philadelphia, Philadelphia, PA, USA
University of Pennsylvania, Philadelphia, PA, USA
Casellas A:
ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
Universitat de Barcelona, Barcelona, Spain
Tshering K:
Lungtenphu Military Hospital, Thimphu, Bhutan
Ribó JL:
Hospital Universitari General de Catalunya, Barcelona, Spain
Sharma R:
Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
Tshering T:
Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
Pradhan D:
Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
Dema K:
Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
Ngai M:
University Health Network-Toronto General Hospital, Toronto, ON, Canada
Munoz-Almagro C:
Hospital Sant Joan de Déu (University of Barcelona), Barcelona, Spain
Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
Universitat Internacional of Catalunya, Barcelona, Spain
Kain KC:
University Health Network-Toronto General Hospital, Toronto, ON, Canada
University of Toronto, Toronto, ON, Canada
Bassat Q:
ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
Hospital Sant Joan de Déu (University of Barcelona), Barcelona, Spain
Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
ICREA, Barcelona, Spain
Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
Green Submitted, gold
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