Clinical Characteristics and Risk Factor Analysis of Severe Mycoplasma pneumoniae Pneumonia in Children

This study aimed to investigate the characteristics of severe Mycoplasma pneumoniae pneumonia (SMPP) in children, identify risk factors, and evaluate early predictive biomarkers. A retrospective analysis was conducted on 945 children diagnosed with Mycoplasma pneumoniae pneumonia (MPP) at Beijing Zhongguancun Hospital from January 2023 to March 2025, dividing patients into SMPP (105 cases) and non-SMPP groups (840 cases). Multivariate logistic regression revealed that fever duration, white blood cell (WBC) count, neutrophil-to-lymphocyte ratio (NLR), and C-reactive protein (CRP) were independent risk factors for SMPP. ROC curve analysis demonstrated strong predictive value for CRP (AUC=0.864), NLR (AUC=0.860), fever duration (AUC=0.755), and WBC (AUC=0.712). Notably, significant differences were observed between groups in clinical features (pulmonary rales, wheezing) and biomarkers (CRP, NLR, WBC, platelets, SAA), with a higher SMPP risk in children with atopic constitution. These findings suggest that CRP, NLR, fever duration, and WBC are valuable for early prediction and guidance of SMPP management.