The Relationship of Serum Zinc Level in Patients with Pneumonia and Its Effect on Their Outcome

Abstract

Background: Pneumonia remains the leading infectious cause of death among children worldwide. Zinc plays a crucial role by activating  numerous enzymes participating in various metabolic and immune functions.

Objective: To evaluate serum zinc levels in children  hospitalized with pneumonia and to investigate the relationship between zinc concentrations, the severity of pneumonia, and patient  outcomes.

Patients and Methods: The study involved 120 children diagnosed with pneumonia, categorized into two groups based on  their need for Pediatric Intensive Care Unit (PICU) admission: Group I: 45 children who required PICU admission, while Group II: 75  children who did not. Comprehensive medical histories, thorough clinical examinations, laboratory tests, radiological evaluations, and  serum zinc measurements were conducted for all participants

Results: Children admitted to the PICU had significantly lower serum zinc  levels (62.8±26.7 μg/dL) compared to those not admitted (93.4±30.2 μg/dL), p<0.001. Severe pneumonia, increased oxygen support, and  mortality were associated with lower serum zinc levels. Serum zinc levels positively correlated with weight, height, BMI, hemoglobin, and  blood pH, and negatively correlated with blood CO₂, C-reactive protein, and hospital stay duration. At a cutoff of <67.1 μg/dL, serum zinc  was able to predict severe cases of pneumonia in children, with sensitivity of 83.1% and specificity of 74.3%. At a cutoff of <47 μg/dL,  serum zinc was able to predict mortality in children with pneumonia, with 80.8% sensitivity and 73.2% specificity.

Conclusion: A deficiency  in zinc was linked to more severe cases of pneumonia, increased necessity for mechanical ventilation, higher mortality rates,  and prolonged hospital stays.