Hematological Parameters and Systemic Inflammatory Markers in Children with Viral Acute Lower Respiratory Tract Infections

Abstract Objective Viral acute lower respiratory tract infections (ALRTIs) are a leading cause of morbidity and mortality in children, particularly those under 5 years. Accurate diagnosis and timely management are crucial to improve outcomes. This study aimed to address the lack of comparative analysis between hematological and systemic inflammatory markers concerning established disease severity scores in children with viral ALRTIs. We sought to evaluate the correlations between these markers and severity scores to identify which parameters provide the most reliable predictive value for assessing the severity of ALRTI diagnoses in this population. Methods This retrospective cross-sectional study included 191 children hospitalized with viral ALRTIs. Hematological parameters and systemic inflammatory markers were analyzed. The pediatric respiratory severity score (PRESS) was used to assess disease severity. Results Significant differences in some hematological parameters and systemic inflammatory markers across severity groups were observed. Significant correlations were found between PRESS and various hematological parameters, including white blood cell count, lymphocyte count, monocyte count, platelet count, red cell distribution width, plateletocrit, and lymphocyte-to-C-reactive protein ratio. Multivariate analysis identified PRESS, hemoglobin level, and mean platelet volume-to-lymphocyte ratio as independent predictors of pediatric intensive care unit (PICU) admission. Receiver operating characteristic analysis revealed that platelet count had the highest area under the curve for predicting PICU admission. Conclusion We found that values of hematological parameters and systemic inflammatory markers together with clinical severity scores can be used to assess the severity of ALRTIs in children. The identified cutoff values for these markers can aid in predicting PICU admission risk.