ArticlePLOS global public health2023
Prognostic accuracy of biomarkers of immune and endothelial activation in Mozambican children hospitalized with pneumonia.
Article in PLOS global public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prognostic value of C-reactive protein levels in pulmonary infections: A systematic review and meta-analysis.Medicine · 2025Pooled it
- Development and validation of a machine learning-driven framework for differentiating pediatric bronchopneumonia from lobar pneumonia: a multicenter investigation.European journal of medical research · 2025Trial
- Trial
- Predicting referral need for febrile children in low-resource community settings in South and Southeast Asia.Nature medicine · 2026Article
- Interleukins in community-acquired pneumonia: from biomarkers to precision medicine.Frontiers in immunology · 2026Review
- Risk stratification of childhood infection using host markers of immune and endothelial activation in Asia (Spot Sepsis): a multi-country, prospective, cohort study.The Lancet. Child & adolescent health · 2025Observational
- Soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) predicts mortality in patients with febrile illness in southern Mozambique.Communications medicine · 2025Article
- Advancing severity grading for risk-differentiated paediatric pneumonia care.The Lancet. Child & adolescent health · 2025Article
- Narrative review of clinical prediction models for paediatric community acquired pneumonia.Paediatric respiratory reviews · 2025Review
- Host biomarkers and parasite biomass are associated with severe malaria in Mozambican children: a case-control study.Scientific reports · 2025Article
- Diagnostic value of miR-193a-5p in severe pneumonia and its correlation with prognosis.Journal of cardiothoracic surgery · 2025Article
- Derivation and Internal Validation of a Novel Risk Assessment Tool to Identify Infants and Young Children at Risk for Post-Discharge Mortality in Dar es Salaam, Tanzania and Monrovia, Liberia.The Journal of pediatrics · 2024Observational
- sTREM-1: A Biomarker of Mortality in Severe Malaria Impacted by Acute Kidney Injury.The Journal of infectious diseases · 2024Article
- Prognostic performance of early immune and endothelial activation markers in mild-to-moderate COVID-19 outpatients: a nested case-control study.Frontiers in immunology · 2024Article
- Defining the role of host biomarkers in the diagnosis and prognosis of the severity of childhood pneumonia: a prospective cohort study.Scientific reports · 2023Article
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Authors and funding
18 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Pneumonia is a leading cause of child mortality. However, currently we lack simple, objective, and accurate risk-stratification tools for pediatric pneumonia. Here we test the hypothesis that measuring biomarkers of immune and endothelial activation in children with pneumonia may facilitate the identification of those at risk of death. We recruited children <10 years old fulfilling WHO criteria for pneumonia and admitted to the Manhiça District Hospital (Mozambique) from 2010 to 2014. We measured plasma levels of IL-6, IL-8, Angpt-2, sTREM-1, sFlt-1, sTNFR1, PCT, and CRP at admission, and assessed their prognostic accuracy for in-hospital, 28-day, and 90-day mortality. Healthy community controls, within same age strata and location, were also assessed. All biomarkers were significantly elevated in 472 pneumonia cases versus 80 controls (p<0.001). IL-8, sFlt-1, and sTREM-1 were associated with in-hospital mortality (p<0.001) and showed the best discrimination with AUROCs of 0.877 (95% CI: 0.782 to 0.972), 0.832 (95% CI: 0.729 to 0.935) and 0.822 (95% CI: 0.735 to 0.908), respectively. Their performance was superior to CRP, PCT, oxygen saturation, and clinical severity scores. IL-8, sFlt-1, and sTREM-1 remained good predictors of 28-day and 90-day mortality. These findings suggest that measuring IL-8, sFlt-1, or sTREM-1 at hospital presentation can guide risk-stratification of children with pneumonia, which could enable prioritized care to improve survival and resource allocation.
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Registered trials
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