Association of Clinical Signs, Host Biomarkers and Etiology With Radiological Pneumonia in Bhutanese Children

• Main Authors: Sophie Jullien PhD (Author), Melissa Richard-Greenblatt PhD (Author), Aina Casellas MSc (Author), Kinley Tshering MSc (Author), Jose Luis Ribó MD (Author), Ragunath Sharma BA (Author), Tashi Tshering MD (Author), Dinesh Pradhan MD (Author), Kumbu Dema BA (Author), Michelle Ngai PhD (Author), Carmen Muñoz-Almagro PhD (Author), Kevin C. Kain PhD (Author), Quique Bassat PhD (Author)
• Format: Book
• Published: SAGE Publishing, 2022-02-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

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.

Item Description

2333-794X
10.1177/2333794X221078698