Clinical profile and outcome of CRP levels in children with acute bronchiolitis: A retrospective, cross-sectional and analytical study

Abstract

Introduction: C-reactive protein (CRP), which is an acute phase reactant and one of the indicators of acute inflammation, has been linked to bacterial coinfections like bacterial pneumonia. Accordingly, identification of CRP levels can be an important indirect marker for viral infections and an indicator for progression of infection and effectiveness of the treatment. Pneumonia elicits a powerful inflammatory response, both locally and systemically with chemotatic cytokine release into the peripheral circulation.Objective: To assess the frequency of elevated CRP in children with acute bronchiolitis and at comparing the clinical characteristics, laboratory and radiological findings, antibiotics use, and outcome according to CRP levels.Methods: This was a retrospective, cross-sectional, and analytical study where the medical records of all patients with a clinical impression of acute bronchiolitis who were admitted to the pediatric department Shaheed Monsur Ali Medical College & Hospital, Dhaka, Bangladesh from January to December 2023 for the period of one year were retrieved. During the study period, a total of 125 patients were admitted with a clinical presentation of acute bronchiolitis. 25 (20%) patients were excluded due to of unavailability of data of CRP levels. The remaining 100 (80%) patients were included in the study.Results: Total of 125 patients were admitted with a clinical presentation of acute bronchiolitis. 25 (20%) patients were excluded due to of unavailability of data of CRP levels. The remaining 100 (80%) patients were included in the study. 53(53.0%) patients were males. The most common clinical presentation was cough (80 (80.0%) patients) followed by fever (70 (70.0%) patients). Antibiotics were used in 80.0% patients. Patients with high CRP were older at presentation (p<0:0001) and had more fever (p<0:0001) and cough (P = 0:002), but lower hemoglobin level (p<0:0001) compared to those with normal CRP. Fever (P = 0:016) and hemoglobin level (p= 0:002) were independent factors.Conclusion: Most children with acute bronchiolitis had high rate of elevated CRP values that did not correlate with the rate of bacterial coinfection. High CRP levels were found in older children, those presented with more fever and cough, and had a lower hemoglobin level despite that those factors were previously reported to be associated with disease severity and bacterial coinfection.