Molecular Distance to Health Transcriptional Score and Disease Severity in Children Hospitalized With Community-Acquired Pneumonia

摘要: Background: Community-acquired pneumonia (CAP) is a leading cause of hospitalization and mortality in children. Diagnosis remains challenging there are no reliable tools to objectively risk stratify patients or predict clinical outcomes. Molecular distance health (MDTH) genomic score that measures the global perturbation transcriptional profile may help classify by disease severity. We evaluated value MDTH assess severity children hospitalized with CAP. Methods: Children CAP matched healthy controls were enrolled prospective observational study. Blood samples obtained for transcriptome analyses within 24 h hospitalization. scores calculated correlated laboratory markers, such as white blood cell count, c-reactive protein (CRP), procalcitonin (PCT), outcomes, including duration fever (LOS). Univariate multivariable logistic regression applied factors associated LOS after Results: Among (n = 152), pyogenic bacteria (PB) detected 16 (11%), Mycoplasma pneumoniae was 41 (28%), respiratory viruses (RV) alone 78 (51%), pathogen 17 (11%) Statistical group comparisons identified 6,726 genes differentially expressed vs. 39). confirmed PB had higher than those RV (p < 0.05) M. 0.01) alone. CRP (r 0.39, p 0.0001), PCT MDTHs 0.24, fever, while only 0.33, 0.0001). Unadjusted showed both longer (OR 1.04 [1-1.07] 1.12 [1.04-1.20], respectively), however, remained significant when adjusting other covariates (aOR 1.11 [1.01-1.22]). Conclusions: In measured admission independently hospitalization, regardless detected. This suggests biomarkers represent promising approach