Objective: Mycoplasma pneumoniae (MP) infection is a common respiratory illness in children, but the factors associated with its severity remain unclear.
Methods: The clinical data of 136 children aged 5 to 12 years with MP infection in our hospital from March 2021 to March 2022 were retrospectively analyzed. According to the severity of the disease, they were divided into a mild group (74 cases) and a severe group (62 cases), and 80 healthy children who underwent physical examination in our hospital during the same period were selected as the control group. The general data, lung function indexes and laboratory examination indexes of the three groups of children were compared. Multivariate Logistic regression was used to analyze the factors affecting the development of severe MP infection in children. Pearson test was used to analyze the correlation between each influencing factor and mild and severe MP infection. The predictive Value of ROC curve analysis for the development of severe MP infection in children.
Results: Univariate analysis showed that levels of white blood cell (WBC), neutrophil (Neu), sedimentation rate (ESR), fibrinogen (Fib), interleukin -5 (IL-5), interleukin -6 (IL-6), procalcitonin (PCT), C-reactive protein (CRP), lactate dehydrogenase (LDH), alanine aminotransferase (GPT), soluble P-selectin, and D-dimer were higher in the group with mild and severe MP pneumonia. Conversely, levels of interferon-γ(IFN-γ), serum calcium, serum phosphorus, 25-(OH)D3, and PLT were lower.. In addition, Multivariate analysis showed that the increase of Neu, IL-5, CRP, LDH, GPT, soluble P-selectin, D- dimer and the decrease of PLT were the risk factors for the development of severe MP infection in children (P < .05). Meanwhile, the AUC of soluble P-selectin, D- dimer level, PLT and their combination were 0.796 (95% CI: 0.729~0.860, sensitivity=82.95%, specificity=80.16%), 0.721 (95% CI: 0.648~0.788, sensitivity=76.21%, specificity=73.65%), 0.820 (95% CI: 0.860, sensitivity=88.36%, specificity=96.42%), and 0.872 (95% CI: 0.823 ~ 0.920, sensitivity=96.42%, specificity=93.28%) respectively.
Conclusion: The levels of serum soluble P-selectin, D- dimer, and PLT had high predictive Value for the development of MP infection. These findings can help clinicians better understand MP and focus on children with elevated p-selectin, d-dimer, and platelet levels, emphasizing the importance of timely treatment and appropriate interventions to prevent complications.