Circulatory Levels of C-Reactive Protein Do Not Predict Community-Acquired Pneumonia in Children: A Case–Control Study

Abstract

Abstract Background: One of the most severe and common childhood infections is community-acquired pneumonia (CAPn). Precise evaluation of the disease severity is crucial for decision-making. C-reactive protein (CRP) is a hepatic “acute-phase inflammatory reactant.” Research on adults with CAPn has exposed that these biomarkers are linked with disease severity, however, data on pediatric age are still restricted. Objectives: The objective of this study was to evaluate the association of and predictability of CRP with the severity of CAPn among children. Materials and Methods: This study was a multicenter, case–control, and included a total of 190 individuals (80 pneumonia patients and 110 healthy controls), with ages ranging from 1 to 30 months. Blood samples were collected to evaluate the white blood cells (WBCs), and CRP levels and to identify the causative agent of pneumonia. The results were compared between the study groups using Statistical Package for the Social Sciences. Results: The results revealed that in 37 (46.3%) pneumonia cases, the causative agents were bacterial, whereas in 28 (35%) cases, the causative agents were viral, and in 15 (18.8%) the causative agent was undetermined. Around half of the participants were on artificial feeding, 80 (42.1%), were on pure breastfeeding, and only 13 (6.8%) were on mixed feeding. The total WBCs and the mean CRP plasma levels were significantly (P = 0.001) higher among the pneumonia patients. The study revealed nonsignificant variations in the WBCs, and CRP plasma levels according to sex and type of feeding. The mean levels of CRP were more elevated among patients with bacterial pneumonia. However, according to receiver operating characteristic curve analysis, CRP serum levels were not significant enough to predict pneumonia from the control subjects. Conclusion: This study concludes that there was an association of CRP with CAPn among pediatric patients, though there was no strong association of CRP with the causative agents. Additional validation of these results in a larger population and prospective cohorts is still desirable.