Serum Zinc Levels in Severe Pneumonia in Under-Five Children: A Prospective Study
Year: 2025
Type: article
Abstract: Background and Objectives: Acute respiratory infection is a leading cause of morbidity and mortality among under-five children in the low- and middle-income countries. Our objectives were to assess the reliability of serum zinc levels as predictor of mortality in children with pneumonia, and to compare serum zinc levels in pneumonia and severe pneumonia. Materials and Methods: This prospective observational study included all children aged 2–59 months with features of pneumonia or severe pneumonia as per the revised World Health Organization guidelines 2014. Serum zinc levels were measured in all children included in the study, whereas the PRISM 3 scoring system was applied only to children with severe disease who were admitted to the pediatric intensive care unit. Serum zinc levels of <80 mcg/dL suggested deficiency. All children were followed up for the predefined primary outcomes – discharge/death. The association of low serum zinc levels in severe pneumonia and the accuracy of serum zinc levels in predicting mortality were assessed using appropriate statistical methods. Results: Of the 100 children enrolled in the study, 54% were <1 year of age (slight male preponderance), and 54% had severe pneumonia. No case fatality in the pneumonia group, but 22.4% in the severe pneumonia group was noted. The mean standard deviation (SD) serum zinc levels were 82.81 (±19.99) mcg/dL in the pneumonia group and 71.98 (±26.61) mcg/dL in the severe pneumonia group ( P = 0.029). The mean (SD) PRISM 3 score was 25.92 (±3.715) in the mortality group, and 1.56 (±7.216) in the discharge group ( P < 0.001). There was a strong negative correlation ( r = −0.708) between serum zinc levels and the PRISM 3 score. PRISM 3 had an area under curve (AUC) of 0.99 (95% CI: 0.92–1.0) whereas serum zinc had AUC of 0.96 (95% CI: 0.87–0.99) with a sensitivity of 92.31%, specificity of 91.95%, positive predictive value of 63.2%, and negative predictive value of 98.8% in predicting mortality in childhood pneumonia. Conclusion: Serum zinc levels can be a simple test to predict mortality in children with pneumonia.
Source: Journal of Pediatric Pulmonology
Authors: S. Bharath, C. S. Jyotirmanju, A. R. Somashekar
Institution: M.S. Ramaiah Medical College
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7077917657