The relationship between hematological parameters and infectious mononucleosis in children: A prospective observational study

Objective: To evaluate the association between hematological parameters and (EBV) in infants and to help with early warning, identification, and intervention in the development of infection. Material and methods: This is a prospective and observational study of all infants admitted to the pediatric emergency department with cervical lymphadenopathy and fever from January 2021 to December 2022. Multivariate analysis was conducted to evaluate the independence of the association between the hematological parameters and the risk of EBV infection. Results: A total of 89 children with fever and lymphadenopathy were enrolled during the study period. While EBV-VCA IgG value was negative in 52 children, EBV-VCA IgM was negative in 47 children. The optimal cut-off value for NLR was ≤ 0.9, with 54.76% sensitivity and 76.6% specificity. The area under the ROC curve for NLR was 0.66. The optimal cut-off value for ALT was 30 mg/dL, with 47.6% sensitivity and 89.3% specificity. The area under the ROC curve for ALT was 0.54. The optimal cut-off value for AST was greater than 31 mg/dL, with 57.1% sensitivity and 68.0% specificity. The area under the ROC curve for AST was 0.64. The optimal cut-off value for lymphocyte was >5.16, with 50% sensitivity and 87.2% specificity. The area under the ROC curve for lymphocyte was 0.67. Conclusion: New inflammatory markers, NLR, MPV, and PDW, have the advantages of being simple, economical, and rapid. They also have a certain sensitivity and specificity for predicting the occurrence of EBV, and have important clinical application value.