Background: Serum prealbumin (PA) levels have been found to have prognostic value in patients with infectious diseases. Objectives: We aimed to determine the relationship between PA levels and clinical outcomes in children with severe Mycoplasma pneumoniae pneumonia (MPP). Methods: We retrospectively reviewed the data of 163 children with severe MPP who were treated in our hospital from January 2015 to December 2017. The demographic and clinical data of the subjects were collected and statistically analyzed.Results: Our cohort was divided into quartiles by PA level. The average D-dimer level, pediatric risk of mortality (PRISM) III score, total length of stay in hospital (TLSH), C-reactive protein/PA ratio, and proportion of patients with invasive intubation significantly decreased as the serum PA level increased. In addition, the PRISM III estimated mortality and the procalcitonin/PA ratio significantly differed among the four PA groups. Binary logistic regression analysis showed that PA level (odds ratio [OR]: 0.846, 95% confidence interval [CI]: 0.773 -0.926, P = 0.000) and invasive intubation (OR: 4.581, 95% CI: 1.730 -12.124, P = 0.002) were independently correlated with PRISM III scores. Multiple linear regression analysis showed that PA level (β = -0.025, 95% CI: -0.048 to -0.002, P = 0.032) was negatively associated with the normal score of TLSH calculated using the Blom formula. Conclusions:The present study demonstrated that in children with severe MPP, low PA levels correlated with increased PRISM III scores and prolonged TLSH, suggesting that low PA levels contribute to the progression of severe MPP and possibly lead to poor outcomes.
Background: The epidemiology of Kawasaki disease (KD) suggests that an infectious agent may be a potential disease trigger in susceptible children. Several studies have shown that the cause of KD may be associated with Mycoplasma pneumoniae (M. pneumoniae) infection. Objectives: We aimed to investigate the relationship between M. pneumoniae infection and coronary artery aneurysm (CAA) in children with KD in China. Methods: From January 2015 to December 2018, a total of 330 children with KD met the inclusion criteria. Relevant data were extracted and analysed. Results: The children were stratified into two groups according to M. pneumoniae infection status. Significant differences were identified in the proportion of patients with fever > 10 days, the occurrence of small CAA, and the average serum sodium, pre-albumin (PA), and albumin levels but not in the occurrence of medium and giant CAA between the two groups. According to binary logistic regression, M. pneumoniae infection (OR: 0.515; 95% CI: 0.309 - 0.860; P = 0.011), serum sodium levels (OR: 0.910; 95% CI: 0.851 - 0.972; P =0.005), and PA (OR: 0.900; 95% CI: 0.854 - 0.949; P ≤ 0.001) levels were independently associated with occurrence of small CAA. Conclusions: We demonstrated that M. pneumoniae infection, serum sodium and PA levels are inversely related to the occurrence of small CAA. These results suggest that M. pneumoniae infection may be associated with a decreased incidence of small CAA. Further large-sample studies are needed.
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