High pretreatment LDH raises mortality risk in children with adenoviral pneumonia

China: A new research from China found that high pretreatment lactate dehydrogenase (LDH) may increase the risk of mortality in children with adenoviral pneumonia (ADVP) as it is associated with disease severity, development of postinfectious bronchiolitis obliterans (PIBO). The study results were published in the journal Frontiers in Pediatrics.  

Adenoviruses are ubiquitous DNA viruses that cause a wide variety of illnesses in children and adults, including pneumonia. Severe adenoviral pneumonia (ADVP) in children has a poor prognosis and a high risk of mortality. Min Zou et al from Guangxi International Zhuang Medical Hospital, China conducted a meta-analysis to evaluate the association between pretreatment lactate dehydrogenase (LDH) and severity, postinfectious bronchiolitis obliterans (PIBO), and mortality in children with ADVP. 

Researchers included relevant observational studies by searching databases like PubMed, Embase, Web of Science, Wanfang, and CNKI databases from inception to August 3, 2022. The results were pooled using a random effect model by incorporating the potential between-study heterogeneity.

Key findings: 

• Nearly 23 studies with 4481 children having ADVP were included in this meta-analysis.
• Children with severe ADVP had a significantly higher level of pretreatment LDH as compared to those with non-severe ADVP.
• The pretreatment LDH was significantly higher in children who developed PIBO as compared to those who did not as per the pooled results. 
• Higher pretreatment LDH of > 500 IU/L was found to be a risk factor for increased mortality during hospitalization. 
• Sensitivity analyses showed consistent results by excluding one dataset at a time. 

Thus, in children with ADVP, high pretreatment LDH may be linked with the severity of the disease, the development of PIBO, and an increased mortality risk. 

Further reading: Lactate dehydrogenase and the severity of adenoviral pneumonia in children: a meta-analysis. doi: 10.3389/fped.2022.1059728