Lactate dehydrogenase and the severity of adenoviral pneumonia in children: A meta-analysis

Min Zou; Yang Zhai; Xiaoping Mei; Xing Wei

doi:10.3389/fped.2022.1059728

Lactate dehydrogenase and the severity of adenoviral pneumonia in children: A meta-analysis

Front Pediatr. 2023 Jan 26:10:1059728. doi: 10.3389/fped.2022.1059728. eCollection 2022.

Authors

Min Zou¹, Yang Zhai^{2

3}, Xiaoping Mei⁴, Xing Wei⁵

Affiliations

¹ Department of Pediatrics, Guangxi International Zhuang Medicine Hospital, Nanning, China.
² Guangxi Key Laboratory of Chinese Medicine Foundation Research, Guangxi University of Chinese Medicine, Nanning, China.
³ International Medical Department, Guangxi International Zhuang Medicine Hospital, Nanning, China.
⁴ Department of Endocrinology, Guangxi International Zhuang Medicine Hospital, Nanning, China.
⁵ Zhuang Medical College, Guangxi University of Chinese Medicine, Nanning, China.

Abstract

Background: Children with severe adenoviral pneumonia (ADVP) have poor prognosis and high risk of mortality. We performed a meta-analysis to evaluate the association between pretreatment lactate dehydrogenase (LDH) and severity, postinfectious bronchiolitis obliterans (PIBO), and mortality in children with ADVP.

Methods: Relevant observational studies were identified by search of PubMed, Embase, Web of Science, Wanfang, and CNKI databases from inception to August 3, 2022. A random effect model was used to pool the results by incorporating the potential between-study heterogeneity.

Results: Overall, 23 studies with 4,481 children with ADVP were included in this meta-analysis. Results of meta-analysis showed that children with severe ADVP had a significantly higher level of pretreatment LDH as compared to those with non-severe ADVP (standard mean difference [SMD]: 0.51, 95% confidence interval [CI]: 0.36 to 0.66, p < 0.001; I ² = 69%). Besides, pooled results also suggested that the pretreatment LDH was significantly higher in children who developed PIBO as compared to those who did not (SMD: 0.47, 95% CI: 0.09 to 0.84, p = 0.02, I ² = 80%). Finally, results of the meta-analysis also confirmed that a higher pretreatment LDH (>500 IU/L) was a risk factor of increased mortality during hospitalization (odds ratio: 3.10, 95% CI: 1.62 to 5.92, p < 0.001, I ² = 0%). Sensitivity analyses by excluding one dataset at a time showed consistent results.

Conclusion: High pretreatment LDH may be associated with disease severity, development of PIBO, and increased risk of mortality in children with ADVP.

Keywords: adenoviral pneumonia; lactate dehydrogenase; meta-analysis; mortality; postinfectious bronchiolitis obliterans; severity.

Publication types

Review

Grants and funding

This study was supported by 2018 Guangxi University Young and Middle-aged Teachers Basic Ability Improvement Project (2018KY0302), Key project of Guangxi International Zhuang Medical Hospital in 2021 (GZ2021012), and Self-funded project of Guangxi Administration of Traditional Chinese Medicine in 2021 (20210036). This study was supported by Guangxi Key Discipline of Traditional Chinese Medicine (No.GZXK-Z-20-62); Guangxi TCM External Treatment Demonstration Base Project (Guangxi TCM Development [2019] No.14), and Guangxi International Zhuang Medical Hospital Green Seedling Program Top Talent Project.