Frontiers in pediatrics · 2026
Differentiated associations of inflammatory indices with laboratory-defined organ injury/involvement and hospitalization length in pediatric respiratory tract infections.
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Wang Jing, Dong Ruotong, Mao Song
Аннотация
BACKGROUND: To analyze the associations of inflammatory indices with laboratory-defined organ injury/involvement and hospitalization length in pediatric respiratory tract infections (RTIs).
METHODS: In this study, logistic regression analyses were performed to examine the associations between inflammatory index levels and laboratory-defined cardiac injury, liver injury, and kidney involvement. Receiver operating characteristic (ROC) curve analyses were performed to evaluate the discriminative ability of inflammatory indices for laboratory-defined organ injury/involvement. Linear regression analyses were conducted to assess the associations between inflammatory index levels and hospitalization length.
RESULTS: Lower levels of neutrophils, C-reactive protein (CRP), Systemic immune inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), neutrophil-to-platelet ratio (NPR), and CRP-to-lymphocyte ratio (CLR) were associated with the presence of laboratory-defined cardiac injury. Higher lymphocyte levels and lower levels of neutrophils, platelets, CRP, SII, NLR, platelet-to-lymphocyte ratio (PLR), NPR, and CLR were associated with the presence of laboratory-defined liver injury. Higher levels of white blood cells (WBCs), neutrophils, CRP, SII, NLR, PLR, and CLR, together with lower lymphocyte levels, were associated with the presence of laboratory-defined kidney involvement. ROC curve analyses suggested that NLR, SII, and CLR had a relatively high discriminative ability for laboratory-defined cardiac injury; SII, NLR, and PLR for liver injury; and NLR, CLR, and NPR for laboratory-defined kidney involvement. Higher levels of WBCs, lymphocytes, CRP, NPR, and CLR, along with lower levels of platelets and Hb, were associated with longer hospitalization.
CONCLUSION: Inflammatory indices, particularly composite indices, were associated with laboratory-defined organ injury/involvement and longer hospitalization in children with RTIs, suggesting their potential value as non-invasive exploratory markers. Future longitudinal studies are needed to confirm their prognostic utility.
METHODS: In this study, logistic regression analyses were performed to examine the associations between inflammatory index levels and laboratory-defined cardiac injury, liver injury, and kidney involvement. Receiver operating characteristic (ROC) curve analyses were performed to evaluate the discriminative ability of inflammatory indices for laboratory-defined organ injury/involvement. Linear regression analyses were conducted to assess the associations between inflammatory index levels and hospitalization length.
RESULTS: Lower levels of neutrophils, C-reactive protein (CRP), Systemic immune inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), neutrophil-to-platelet ratio (NPR), and CRP-to-lymphocyte ratio (CLR) were associated with the presence of laboratory-defined cardiac injury. Higher lymphocyte levels and lower levels of neutrophils, platelets, CRP, SII, NLR, platelet-to-lymphocyte ratio (PLR), NPR, and CLR were associated with the presence of laboratory-defined liver injury. Higher levels of white blood cells (WBCs), neutrophils, CRP, SII, NLR, PLR, and CLR, together with lower lymphocyte levels, were associated with the presence of laboratory-defined kidney involvement. ROC curve analyses suggested that NLR, SII, and CLR had a relatively high discriminative ability for laboratory-defined cardiac injury; SII, NLR, and PLR for liver injury; and NLR, CLR, and NPR for laboratory-defined kidney involvement. Higher levels of WBCs, lymphocytes, CRP, NPR, and CLR, along with lower levels of platelets and Hb, were associated with longer hospitalization.
CONCLUSION: Inflammatory indices, particularly composite indices, were associated with laboratory-defined organ injury/involvement and longer hospitalization in children with RTIs, suggesting their potential value as non-invasive exploratory markers. Future longitudinal studies are needed to confirm their prognostic utility.