Serum zinc level: a prognostic marker for severe pneumonia in children

ABSTRACT

Background: Pneumonia is one of the leading causes of under 5 mortality among children in developing countries. Zinc deficiency is postulated as cause of severe pneumonia, but evidences shows conflicting results on whether serum zinc levels predicts the severity of pneumonia. So prospective study was undertaken to study the relationship between serum zinc levels and severity of pneumonia in children with community acquired pneumonia.Methods: Fifty cases of pneumonia (group 1) and 50 cases of severe pneumonia (group 2) according to WHO classification were enrolled into the study. Demography, anthropometry and immunization status were recorded. A single zinc measurement was performed for all the patients within 24 hours of admission. The severity, clinical course including recovery to discharge was compared between two groups with respect to their serum zinc levels.Results: Mean ('SD) age group of the study population was 22 months'16.05 and 21.88 months'15.97 months in boys and girls respectively. Pneumonia was high in girls (59%) and children between 2 to <12 months had higher (36%) infection rate. Mean zinc level in pneumonia and severe pneumonia group were 68.69'g/dl'28.77 and 68.08'g/dl'27.55 respectively. There was no difference in the nutritional status (weight for height and height for age) of the study group. Serum Zn level was low in 56 % and 52% of pneumonia and severe pneumonia group respectively. Comparison of serum zinc levels between the ARTI groups did not achieve statistical significance (p=0.430). However, the duration of recovery is earlier than 1 week in pneumonia cases when compared to severe pneumonia patients (p<0.001, OR 1.375).Conclusions: Normal zinc levels was associated with early recovery in simple pneumonia patient, so study of serum zinc levels in severe pneumonia patients has prognostic value.