Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Jun 9, 2023; 12(3): 115-124
Published online Jun 9, 2023. doi: 10.5409/wjcp.v12.i3.115
Clinical characteristics of community-acquired pneumonia in children caused by mycoplasma pneumoniae with or without myocardial damage: A single-center retrospective study
Shukri Omar Yusuf, Peng Chen
Shukri Omar Yusuf, Peng Chen, Department of Pediatrics, The Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
Author contributions: Yusuf SO conducted data collection, analysis, and manuscript drafting; Chen P conceived the study and supervised the entire study process; All authors read and approved the final manuscript.
Institutional review board statement: The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Institutional Review Board of The Second Hospital of Jilin University (In 2022, research review No. 073). Parents of all eligible children gave their informed consent for inclusion before they were admitted to the hospital. The confidentiality of the patients was ensured throughout the study.
Informed consent statement: This study consists of two parts: (1) We collected children’s medical history, diagnosis and supplementary examination in the inpatients department through the hospital computer; and (2) the results of this study may provide information for future clinical activities. At the same time, we will keep the children’s information and privacy strictly confidential. We promise to use it only for this study. Without permission, we will not disclose this information to third parties. We make every effort to protect the privacy of the personal medical data. We will not use any patients name or patients ID.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
Data sharing statement: No additional data is available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Peng Chen, Doctor, Chief Physician, Department of Pediatrics, The Second Hospital of Jilin University, Yatai Street, Changchun 130041, Jilin Province, China. c_p@jlu.edu.cn
Received: December 3, 2022
Peer-review started: December 3, 2022
First decision: February 21, 2023
Revised: March 8, 2023
Accepted: March 30, 2023
Article in press: March 30, 2023
Published online: June 9, 2023
Abstract
BACKGROUND

Mycoplasma pneumoniae (MP) is a prevalent pathogen that causes respiratory infections in children and adolescents.

AIM

To assess the differences in the clinical features of MP-associated community-acquired pneumonia (CAP) in children who presented with mild or severe mycoplasma pneumoniae pneumonia (MPP); to identify the incidence of myocardial damage between the two groups.

METHODS

This work is a retrospective study. We identified children between 2 mo and 16 years of age with clinical and radiological findings consistent with CAP. We admitted patients to the inpatient department of the Second Hospital of Jilin University, Changchun, China, from January 2019 to December 2019.

RESULTS

A total of 409 hospitalized patients were diagnosed with MPP. Among them were 214 (52.3%) males and 195 (47.7%) females. The duration of fever and cough was the longest in severe MPP cases. Similarly, plasma levels of highly sensitive C-reactive protein (t = -2.834, P < 0.05), alanine transaminase (t = -2.511, P < 0.05), aspartate aminotransferase (t = -2.939, P < 0.05), and lactate dehydrogenase (LDH) (t = -2.939, P < 0.05) were all elevated in severe MPP cases compared with mild MPP cases, and these elevations were statistically significant (P < 0.05). Conversely, the neutrophil percentage was significantly lower in severe MPP cases than in mild MPP cases. The incidence of myocardial damage was significantly higher in severe MPP cases than in mild MPP cases (χ2 = 157.078, P < 0.05).

CONCLUSION

Mycoplasma pneumoniae is the main cause of CAP. The incidence of myocardial damage was higher and statistically significant in severe MPP cases than in mild MPP cases.

Keywords: Community-acquired pneumonia, Mycoplasma pneumoniae, Mild mycoplasma pneumoniae pneumonia, Severe mycoplasma pneumoniae pneumonia, Myocardial damage

Core Tip: Our study highlighted which clinical parameters should be focused on to differentiate between mild and severe mycoplasma pneumoniae pneumonia (MPP), which is crucial for pediatricians as it would enable us to make a quick diagnosis and consequently prompt treatment in case of severe MPP. We found that the duration of fever and cough was longer in the severe MPP group than in the mild MPP group. Similarly, the high sensitivity C-reactive protein levels, procalcitonin, alanine transaminase, aspartate aminotransferase, and lactate dehydrogenase were significantly higher in the severe MPP cohort than in the mild MPP group. Paradoxically, the neutrophil count was significantly higher in the mild MPP group than in the severe MPP group. More importantly, the incidence of myocardial damage was significantly higher in the severe MPP group than in mild MPP cases. However, it is unknown whether there is a causal link between severe MPP and myocardial damage; therefore, to ascertain this hypothesis, future research is recommended.