Objective: There is a crucial balance between oxidant and antioxidant defense mechanisms. We aimed to evaluate the role of the balance of these systems in community-acquired pneumonia (CAP) in children. Methods: We analyzed serum oxidant and antioxidant stress parameters according to the clinical and demographic data of children with CAP and compared them with healthy controls. Serum total antioxidant status (TAS), total oxidant status (TOS), and levels of ischemia-modified albumin (IMA), antioxidant enzymes, non-enzymatic antioxidant factors, and plasma thiol were evaluated and compared between the groups. Results: Of 160 children evaluated, 106 had CAP (54 outpatients, 52 inpatients) and the other 54 were healthy subjects (control group). Total thiol and native thiol levels were significantly lower in the inpatient group compared to the outpatient group (p=0.004, p=0.005). Serum IMA differed significantly among the groups (p=0.001), with inpatients showing the highest level. A positive correlation was found between serum IMA and C-reactive protein levels in patients with pneumonia (r=0.351; p=0.001). Conclusion: Parameters that provide information about antioxidant capacity may be useful in the diagnosis and prognosis of pneumonia. Both thiol homeostasis parameters and IMA level seem likely to be influenced by disease severity. Our results suggest that plasma thiol levels and IMA may be good candidate biomarkers to predict the severity of pneumonia in children.
Background: Lung ultrasound (LUS) has been successfully used in the diagnosis of different pulmonary diseases. Present study design to determine the diagnostic value of LUS in the evaluation of children with COVID-19, and to compare chest X-ray and LUS results with tomography (CT). Method and objectives: In this prospective multi-center study, 40 children with confirmed COVID-19 were included. LUS was performed to all patients at admission. The chest X‐ray and CT were performed according to the decision of the primary physicians. LUS results were compared with chest X-ray and CT. The sensitivity and specificity and diagnostic performance was determined. Results: Of the 40 children median (range) was 10.5 (0.4-17.8) years. Chest X-ray and LUS were performed on all and chest CT was performed on 28 (70%) patients at the time of diagnosis. Sixteen (40%) patients had no apparent chest CT abnormalities suggestive of COVID-19, whereas 12 (30%) had abnormalities. LUS confirmed the diagnosis of pulmonary involvement in 10 out of 12 patients with positive CT findings. LUS demonstrated normal lung patterns among 15 patients out of 16 who had normal CT features. The sensitivity identified by the chest X-ray and LUS tests was comparedand statistically significantly different (p=0.016). Chest X-ray displayed false-negative results for pulmonary involvement in 75% whereas for LUS it was 16.7%. Conclusions: LUS might be a useful tool in the diagnostic steps of children with COVID-19. A reduction in chest CT assessments may be possible when LUS is used in the initial diagnostic steps for these children.