Predictive value of serum copeptin as a severity marker of community-acquired pneumonia in pediatrics

Abstract

Background: Community-acquired pneumonia is the most severe form of acute respiratory infections, inflammatory markers are needed to asses severity and complications for better prognosis Objectives: This study aimed to assess the level of serum copeptin as inflammatory marker in children with CAP compared to controls, and to assess the level of serum copeptin in complicated cases of CAP compared to uncomplicated ones. Patients and Methods: A case-control study was conducted on 53 children with community acquired pneumonia and another 40 children as controls, they were further subdivided according to presence or absence of complications of pneumonia into complicated cases(27 patients) and non complicated cases (26 patients), admitted to Pediatric Hospital Ain shams University from January 2021 to the end of December 2021.Blood samples for copeptin and procalcitonin were drawn and sent for analysis. Imaging techniques as X-ray, computed topography and ultrasound were used to assess the diagnosis of pneumonia. Results: Blood level of copeptin was statistically significant higher in pneumonia cases(median 65 pmol/L) compared to controls (median 0.65 pmol/L) (P-value <0.001).Blood level of copeptin was statistically significant higher in complicated pneumonia cases (n=27 patients, median 79 pmol/L) compared to uncomplicated cases (n=26 patients, median 37 pmol/L) (P-value< 0.001).Blood level of copeptin was statistically significant positively correlated with all pneumonia severity scores and to procalcitonin level. Sensitivity and Specificity of blood level of copeptin (sensitivity 81%, specificity 84%) were significantly higher than that of procalcitonin (sensitivity 62% and specificity 73%). Conclusion: We conclude that serum copeptin might represent a new biomarker for predicting CAP related complications and severity among pediatric population.