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Published on: June 28, 2018
Dynamics of platelet parameters in children with severe community-acquired pneumonia between viral and bacterial
Chaonan Fan1,2, Yiyang Mao1,2, Jun Liu1,2
1Department of Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
Insights
Platelet count (PLT) differences in children with severe community-acquired pneumonia (CAP) may help distinguish viral from bacterial infections. However, PLT alone has limited diagnostic value for these pediatric infections.
Area of Science:
- Pediatrics
- Infectious Diseases
- Hematology
Background:
- Platelet parameters can differ based on pathogens.
- Limited knowledge exists on platelet parameter variations in children with severe community-acquired pneumonia (CAP) due to viral versus bacterial infections.
Purpose of the Study:
- To investigate and compare dynamic changes in platelet parameters in children with severe CAP caused by viral, bacterial, or coinfections.
Main Methods:
- A retrospective study of 156 children with severe CAP.
- Dynamic monitoring of platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT) at multiple time points.
Main Results:
- At 72 hours, PLT was significantly lower in the viral infection group compared to bacterial and coinfection groups.
- Receiver operating characteristic analysis indicated PLT at 72 hours could aid in distinguishing infection types (AUC=0.683), though with moderate sensitivity (68%) and specificity (65%).
Conclusions:
- Platelet parameters have limited diagnostic value for differentiating bacterial and viral infections in pediatric severe CAP.
- Combined with other indicators, platelet parameters may offer a reference for timely treatment decisions in severe pediatric pneumonia.
Background:
Changes in platelet parameters may vary according to the different pathogens. However, little is known about the differences in platelet parameters in children with severe community-acquired pneumonia (CAP) children of viral and bacterial infections.
Methods:
This was a single-center retrospective study that included 156 children with severe CAP. Dynamic changes in platelet parameters, including platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT), were recorded at 24 h, 48 h, 72 h, and day 7 of admission, as well as at discharge.
Results:
At 72 h of admission, PLT in the viral infection group was significantly lower than that in the bacterial infection and bacterial and viral coinfections group. Meanwhile, the curve of changes in PLT (ΔPLT) in the viral infection group was clearly separated from the other two groups at this time point. Receiver operating characteristic (ROC) analysis showed that PLT at 72 h of admission could assist in distinguishing bacterial and viral infections in severe pneumonia children with the area under curve (AUC) value of 0.683 [95% confidence interval (CI): 0.561-0.805, P=0.007]. However, its sensitivity and specificity were not high, at 68% and 65%, respectively.
Conclusions:
Although the diagnostic value of platelet parameters in bacterial and viral infection in children with severe CAP is limited, they are still expected to be combined with other indicators to provide a reference for timely treatment.
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