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Association of Atopy with Disease Severity in Children with Mycoplasma pneumoniae Pneumonia
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  • Chen-rong Bian,
  • SongTao Li,
  • BeiBei Yang,
  • PingPing Wang,
  • Wen-hong Li,
  • Sheng-gang Ding
Chen-rong Bian
First Affiliated Hospital of Anhui Medical University
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SongTao Li
First Affiliated Hospital of Anhui Medical University
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BeiBei Yang
First Affiliated Hospital of Anhui Medical University
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PingPing Wang
First Affiliated Hospital of Anhui Medical University
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Wen-hong Li
First Affiliated Hospital of Anhui Medical University
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Sheng-gang Ding
First Affiliated Hospital of Anhui Medical University

Corresponding Author:[email protected]

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Abstract

Background: Mycoplasma pneumoniae pneumonia (MPP) is common among children, but the impact of atopy on MPP severity in children is unknown. This study investigated whether atopic vs. nonatopic children had greater MPP severity. Methods: Of 539 children (ages 3-14 years) diagnosed with MPP between January 2018 and December 2021 in the First Affiliated Hospital of Anhui Medical University and enrolled in this study, 195 were atopic and 344 were nonatopic. Of them, 204 had refractory MPP, and 335 had general MPP. Data on demographic and clinical characteristics, laboratory findings, clinical treatments, lung function, and fibrobronchoscopy results were analyzed. Results: Significantly more boys with MPP were atopic than nonatopic ( P<0.05). More atopic (than nonatopic) children presented with prolonged fever and hospitalization, severe extra-pulmonary complications, steroid treatment, wheezing, and increased IgE levels (all P<0.05). In atopic (vs. nonatopic) children with MPP, the incidence of mucosal inflammation with lymphoid follicular hyperplasia and segmental pneumonia was significantly increased and required bronchoscopy-assisted and steroid therapy. Compared with nonatopic children, more atopic children developed refractory MPP ( P<0.05). Prolonged fever and hospitalization, severe extra-pulmonary complications, lymphocyte count, procalcitonin and lactate dehydrogenase levels, and percentages of atopy were all significantly higher ( P<0.05) among children with refractory MPP vs. general MPP. Spearman correlation analysis showed strong associations between atopy and male sex, length of hospital stay, fever duration, IgE level, wheezing, segmental pneumonia, refractory MPP, and treatment with hormones or bronchoscopy ( P<0.05). Conclusions: Atopy may be a risk factor for and was positively correlated with the severity of MPP in children.