AUTHOR=Zou Min , Zhai Yang , Mei Xiaoping , Wei Xing 

TITLE=Lactate dehydrogenase and the severity of adenoviral pneumonia in children: A meta-analysis

JOURNAL=Frontiers in Pediatrics

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2022.1059728

DOI=10.3389/fped.2022.1059728

ISSN=2296-2360

ABSTRACT=<sec><title>Background</title><p>Children with severe adenoviral pneumonia (ADVP) have poor prognosis and high risk of mortality. We performed a meta-analysis to evaluate the association between pretreatment lactate dehydrogenase (LDH) and severity, postinfectious bronchiolitis obliterans (PIBO), and mortality in children with ADVP.</p></sec><sec><title>Methods</title><p>Relevant observational studies were identified by search of PubMed, Embase, Web of Science, Wanfang, and CNKI databases from inception to August 3, 2022. A random effect model was used to pool the results by incorporating the potential between-study heterogeneity.</p></sec><sec><title>Results</title><p>Overall, 23 studies with 4,481 children with ADVP were included in this meta-analysis. Results of meta-analysis showed that children with severe ADVP had a significantly higher level of pretreatment LDH as compared to those with non-severe ADVP (standard mean difference [SMD]: 0.51, 95% confidence interval [CI]: 0.36 to 0.66, <italic>p</italic> &lt; 0.001; <italic>I</italic><sup>2</sup> = 69%). Besides, pooled results also suggested that the pretreatment LDH was significantly higher in children who developed PIBO as compared to those who did not (SMD: 0.47, 95% CI: 0.09 to 0.84, <italic>p</italic> = 0.02, <italic>I</italic><sup>2</sup> = 80%). Finally, results of the meta-analysis also confirmed that a higher pretreatment LDH (&gt;500 IU/L) was a risk factor of increased mortality during hospitalization (odds ratio: 3.10, 95% CI: 1.62 to 5.92, <italic>p</italic> &lt; 0.001, <italic>I</italic><sup>2</sup> = 0%). Sensitivity analyses by excluding one dataset at a time showed consistent results.</p></sec><sec><title>Conclusion</title><p>High pretreatment LDH may be associated with disease severity, development of PIBO, and increased risk of mortality in children with ADVP.</p></sec>