Factors associated with pulmonary embolism in children with severe Mycoplasma pneumoniae pneumonia.

Authors

Xuelian Chang, Liangkai Zhang, Zhongxiao Zhang, Xiaodi Tang, Mengjiao Zhao, Qian Li, Linlin Han, Jing Ma, Xiuli Yan

Published in

Frontiers in immunology. Volume 17. Pages 1900602. Epub Oct 09, 2026.

Abstract

To investigate the clinical characteristics and factors for pulmonary embolism (PE) in children with severe Mycoplasma pneumoniae pneumonia (SMPP).
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.
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%.
Early clinical signs of pulmonary embolism (PE) in children with SMPP include nonspecific prolonged fever, elevated inflammatory markers, increased D-dimer, and cardiovascular complications.

PMID:
42920462
Bibliographic data and abstract were imported from PubMed on 24 Oct 2026.

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