Factors associated with pulmonary embolism in children with severe Mycoplasma pneumoniae pneumonia
- 1Respiratory and Interventional Radiology, Children’s Hospital Affiliated to Shandong University/Jinan Children’s Hospital
Abstract
Background: To investigate the clinical characteristics and factors for pulmonary embolism (PE) in children with severe Mycoplasma pneumoniae pneumonia (SMPP).
Methods: This retrospective study included pediatric patients with SMPP hospitalized at the Affiliated Children’s Hospital of Shandong University between October 2019 and March 2025. They were divided into the PE and control groups based on the presence/absence of PE. Multivariable logistic regression analysis was performed to identify factors independently associated with PE in children with SMPP. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve was calculated to evaluate the discriminative ability of the identified factors.
Results: Among the 199 children with SMPP included in this study, 100 were diagnosed with PE and 99 served as controls. The mean age was 6.73 ± 1.79 years in the PE group and 6.57 ± 1.70 years in the control group. The mean interval from symptom onset to PE diagnosis was 17 days. The multivariable logistic regression analysis indicated that duration of fever (OR = 1.122, 95%CI: 1.040-1.211, P = 0.003), extrapulmonary symptoms (OR = 3.479, 95%CI: 1.853-6.535, P<0.001), NEU (OR = 1.355, 95%CI: 1.131-1.624, P = 0.001), ESR (OR = 1.024, 95%CI: 1.003-1.047, P = 0.028), APTT (OR = 0.926, 95%CI: 0.866-0.990, P = 0.025), D-dimer level (OR = 1.210, 95%CI: 1.111-1.319, P<0.001), and cardiovascular complications (OR = 9.500, 95%CI: 1.759-51.316, P = 0.009) were independently associated with PE in children with SMPP. D-dimer showed the largest AUC (AUC = 0.806), with a sensitivity of 75% and a specificity of 74%.
Conclusion: Early clinical signs of pulmonary embolism (PE) in children with SMPP include nonspecific prolonged fever, elevated inflammatory markers, increased D-dimer, and cardiovascular complications.
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BibTeX
@article{chang2026factors,
title = {{Factors associated with pulmonary embolism in children with severe Mycoplasma pneumoniae pneumonia}},
author = {Xuelian Chang and Liangkai Zhang and Zhongxiao Zhang and Xiaodi Tang and Mengjiao Zhao and Qian Li and Linlin Han and Jing Ma and Xiuli Yan},
journal = {Frontiers in Immunology},
year = {2026},
month = oct,
doi = {10.3389/fimmu.2026.1900602},
url = {https://www.frontiersin.org/articles/10.3389/fimmu.2026.1900602/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Factors associated with pulmonary embolism in children with severe Mycoplasma pneumoniae pneumonia
AU - Xuelian Chang
AU - Liangkai Zhang
AU - Zhongxiao Zhang
AU - Xiaodi Tang
AU - Mengjiao Zhao
AU - Qian Li
AU - Linlin Han
AU - Jing Ma
AU - Xiuli Yan
PY - 2026
DA - 2026/10/09
JO - Frontiers in Immunology
DO - 10.3389/fimmu.2026.1900602
UR - https://www.frontiersin.org/articles/10.3389/fimmu.2026.1900602/full
AB - Background: To investigate the clinical characteristics and factors for pulmonary embolism (PE) in children with severe Mycoplasma pneumoniae pneumonia (SMPP). Methods: This retrospective study included pediatric patients with SMPP hospitalized at the Affiliated Children’s Hospital of Shandong University between October 2019 and March 2025. They were divided into the PE and control groups based on the presence/absence of PE. Multivariable logistic regression analysis was performed to identify factors independently associated with PE in children with SMPP. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve was calculated to evaluate the discriminative ability of the identified factors. Results: Among the 199 children with SMPP included in this study, 100 were diagnosed with PE and 99 served as controls. The mean age was 6.73 ± 1.79 years in the PE group and 6.57 ± 1.70 years in the control group. The mean interval from symptom onset to PE diagnosis was 17 days. The multivariable logistic regression analysis indicated that duration of fever (OR = 1.122, 95%CI: 1.040-1.211, P = 0.003), extrapulmonary symptoms (OR = 3.479, 95%CI: 1.853-6.535, P<0.001), NEU (OR = 1.355, 95%CI: 1.131-1.624, P = 0.001), ESR (OR = 1.024, 95%CI: 1.003-1.047, P = 0.028), APTT (OR = 0.926, 95%CI: 0.866-0.990, P = 0.025), D-dimer level (OR = 1.210, 95%CI: 1.111-1.319, P<0.001), and cardiovascular complications (OR = 9.500, 95%CI: 1.759-51.316, P = 0.009) were independently associated with PE in children with SMPP. D-dimer showed the largest AUC (AUC = 0.806), with a sensitivity of 75% and a specificity of 74%. Conclusion: Early clinical signs of pulmonary embolism (PE) in children with SMPP include nonspecific prolonged fever, elevated inflammatory markers, increased D-dimer, and cardiovascular complications.
SN - 1664-3224
ER -