Objective To explore the characteristics of coagulation and immune function and their clinical significance in children with severe adenovirus pneumonia (SAP).
Methods A total of 122 children with SAP and 120 children with non-severe adenovirus pneumonia (NSAP) were enrolled and assigned to severe group and non-severe group. The severe group was further subdivided into good prognosis subgroup (n=105) and poor prognosis subgroup (n=17) according to prognosis. Additionally, 120 healthy children undergoing physical examination during the same period were included as control group. Coagulation function indicators, including prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), and thrombin time (TT) were measured. Levels of immunoglobulin A (IgA), immunoglobulin G (IgG), and immunoglobulin M (IgM) were determined using the nephelometric immunoassay. Multivariate Cox regression analysis was conducted to explore the influencing factors of poor prognosis.
Results Compared with the control group, children in both the non-severe and severe groups exhibited increased levels of white blood cells (WBC), neutrophils (N), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), interleukin-6 (IL-6), procalcitonin (PCT), FIB, and IgG, as well as decreased levels of B lymphocytes, natural killer (NK) cells, PT, APTT, IgA, and IgM (P < 0.05). Compared with the non-severe group, children in the severe group showed increased levels of WBC, N, CRP, ESR, IL-6, PCT, FIB, and IgG, as well as decreased levels of B lymphocytes, NK cells, PT, APTT, IgA, and IgM (P < 0.05). Compared with the good prognosis subgroup, the poor prognosis subgroup exhibited increased levels of CRP, IL-6, PCT, and IgG, as well as decreased levels of APTT, IgM, and IgA (P < 0.05). The results of multivariate Cox regression analysis showed that PCT, APTT, and IgM were influencing factors of poor prognosis in children with SAP (P < 0.05).
Conclusion Children with SAP have decreased levels of PT, APTT, IgA, and IgM, as well as increased levels of FIB and IgG. Coagulation and immune function indicators are correlated with the prognosis of SAP.
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