Serum Selenium and Iron as Predictors of Disease Severity and Nutritional Status in Children with Community-Acquired Pneumonia | ||
| Zagazig University Medical Journal | ||
| Articles in Press, Accepted Manuscript, Available Online from 08 November 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/zumj.2025.431152.4244 | ||
| Authors | ||
| Usama Mahmoud Alkholy1; Esraa Barakat Abdelmoneam Mostafa* 2; Heba Fouad Pasha3; Ahmed U. Alkholy4; Ghada Mohammed Abdellatif5 | ||
| 1Professor of Pediatrics, Faculty of Medicine, Zagazig University | ||
| 2MBBCH, Faculty of Medicine, Zagazig University | ||
| 3Professor of Medical Biochemistry, Faculty of Medicine, Zagazig University | ||
| 4MBBCH, Faculty of Medicine, Cairo University | ||
| 5Assistant Professor of Pediatrics, Faculty of Medicine, Zagazig University | ||
| Abstract | ||
| Background: Pediatric community-acquired pneumonia remains a major cause of morbidity and mortality. Selenium (Se) and iron (Fe) influence host redox balance and “nutritional immunity,” but their relationship to clinical severity in children is not well established. Methods: A cross-sectional study was done on 60 children with CAP admitted to the Pediatric Chest Unit, Zagazig University. Respiratory distress was graded I–IV. Results: Respiratory distress grades were : I (33.3) %, II (33.3) %, III (15.0) %, IV (18.3) %. Oxygen support included: nasal prongs 75.0%, mask 6.7% and mechanical ventilation 18.3%. PICU admission were required in 33.3%. Median (IQR) Fe levels decreased across distress grades (grade I: 76.5; grade II: 70; grades III-IV: 52 µg/dL; Kruskal–Wallis=9.796, p=0.007; pairwise p=0.044 and 0.002). Se likewise declined (grade I: 72.44; grade II: 66.78; grades III-IV: 29.24 µg/dL .Cutoffs predicting grades III – IV distress: Fe ≤ 67 µg/dL (AUC 0.734; sensitivity 90%; specificity 55%; PPV 50%; NPV 91.7%; accuracy 66.7%; p=0.003) and Se ≤ 69.62 µg/dL (AUC 0.763; sensitivity 80%; specificity 52.5%; PPV 45.7%; NPV 84%; accuracy 61.7%; p=0.001). same cutoffs predicted PICU admission with identical performance metrics. Conclusion: Both serum selenium and iron showed a progressive decline increasing severity, and cutoffs of ≤69.62 µg/dL for selenium and ≤67 µg/dL for iron demonstrated moderate accuracy in predicting severe illness supporting the role of selenium and iron as potential biochemical markers of severity in pediatric | ||
| Keywords | ||
| Serum Selenium; Iron; with Disease Severity; Pediatric; Community-Acquired Pneumonia | ||
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