Estimation of Hematological Parameters Including Neutrophil-to-lymphocyte Ratio, Platelet-to-lymphocyte Ratio, and Red Cell Distribution Width in Childhood Community-acquired Pneumonia and Its Relation with the Disease Severity: A Case-Control Study.

INTRODUCTION

Community-acquired pneumonia (CAP) remains a leading cause of illness and death in children under five. Early identification of severe cases is critical. This study evaluates hematological parameters - neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), red cell distribution width (RDW), and thrombocytopenia - as prognostic markers in pediatric CAP.

MATERIALS AND

METHODS

A case-control study was conducted among 400 children aged 2-59 months with CAP at a tertiary care hospital. There were 3 groups labeled as a control group and a patient group, which is divided into pneumonia and severe pneumonia groups based on the Integrated Management of Neonatal and Child hood Illness (IMNCI) guidelines. Hematological indices were analyzed using t-tests, Chi-square tests, and receiver operating characteristic curve analysis.

RESULTS

Among 400 participants aged 2-59 months, younger age (2-20 months) and male gender were associated with higher pneumonia severity. Hemoglobin, hematocrit, NLR, PLR, and RDW showed statistically significant associations with pneumonia severity. The NLR correlates with the severity of pneumonia. The PLR correlates statistically with pneumonia severity, evidenced by a statistically significant P value. RDW is considered an important parameter for assessing pneumonia severity, demonstrated by a highly significant P value. Hence, these parameters emerged as a promising inflammatory marker for severe pediatric pneumonia.

CONCLUSION

NLR, PLR, RDW, and thrombocytopenia are simple, cost-effective markers that can aid in early identification of severe pediatric CAP, improving clinical outcomes.