Association of lung consolidation with clinical prognosis in children with Mycoplasma pneumoniae pneumonia: a retrospective study

Abstract Objectives Lung consolidation is common in patients with Mycoplasma pneumoniae pneumonia (MPP). In this study, we aimed to investigate whether this lung lesion associated with the severity and prognosis of MPP. Methods Clinical experts reassessed and collected the clinical characteristics, imaging features, and laboratory examination of 752 hospitalized children with MPP who received low-dose computerized tomography (CT) examination between August 2014 and July 2019. We evaluated the impact of lobar consolidation on the fever duration and length of hospital stay using Kaplan-Meier analysis and COX model. The relationship between lobar consolidation and inflammatory markers was also determined, as well as hospital charges. Results Among the 752 patients included, 90.3% (679/752) presented lung consolidation, 25.1% (189/752) with 2 or more lobar consolidation, and 16.2% (122/752) patients developed severe MPP (SMPP). Beyond pleural effusion, lobar consolidation had the highest risk of SMPP among low-dose CT imaging-based evidence. Compared with 0 and 1 lobar consolidation, 2 lobes, 3 lobes, and 4 lobes were associated with a 1-fold, 3.1-fold, and 7.5-fold increased risk of SMPP (OR 2.0 [95% CI 1.3–3.2], OR 4.1 [95% CI 2.0–8.5], OR 8.5 [95% CI 2.2–32.6]). The length of stay and fever duration were prolonged correspondingly with increase of number of lobar consolidation, as were hospital charges. Conclusion Lobar consolidation is a stable and reliable CT feature for assessing of severity of illness and clinical prognosis for children with MPP.