2021, Vol. 4, Issue 2, Part A

Background: Pneumonia is the leading cause of morbidity and mortality in children aged below 5 years. Pneumonia is responsible for about 19% of all deaths in this age group. As per the data published by World Health Organization, 10.5 million children under the age of 2 years across the world lose their lives due to 5 preventable and curable diseases every year. Respiratory tract infections are responsible for 28% of all these deaths. Of the total 156 million new episodes each year worldwide, approximately 43(24%) million cases take place in India. Approximately 95% of pneumonia related deaths occur in developing countries and the youngest age group has the highest risk of death.

Zinc is known to protect children from respiratory tract infections by its role in regulation of immunomodulators, immuno regulators, protection of the epithelium of the respiratory tract from infections and improvement of T-lymphocytes.

Zinc is also an important antioxidant and a cytoprotective agent which acts against toxins and inflammatory mediators which damage the respiratory epithelium. Even a mild and moderate deficiency of Zinc impairs the function of the immune system, thus resistance against the infections is reduced and T-lymphocytes could not exhibit sufficient effectiveness. Recent works have provided conflicting evidence on the role of zinc against pneumonia. While some studies, report that there are no significant difference in blood zinc levels in pediatric pneumonia, some other studies have shown significant reduction in the blood zinc levels in pediatric pneumonia when compared to controls.

Hence the present study was conducted with an intent to estimate serum zinc levels in pediatric Pneumonia.

1.To study Serum zinc levels in children hospitalised with pneumonia

2.To assess the correlation between serum zinc levels and severity of pneumonia and its complications.

Methodology of Study: This cross sectional study included 100 subjects aged between 6 months and 5 years. A detailed history, clinical examination, chest X-ray findings, arterial oxygen saturation(SpO2), haemoglobin (g/dl), WBC count and serum zinc levels(micg/dl) was noted.

Results: Mean serum zinc levels in cases was significantly low compared to age and sex matched controls (p value-0.001). Low serum zinc levels was associated with increasing severity of pneumonia (Pneumonia-120.4/dl, severe pneumonia-64.7/dl, very severe pneumonia-40.7/dl). Mean serum zinc levels in complicated pneumonia and death cases was very low compared to those with no complications and who were discharged. Low serum zinc levels were associated with prolonged hospital stay. Indoor smoking emerged as a significant risk factor for pneumonia.

Conclusion: Serum zinc levels is low in children with pneumonia and Low serum zinc levels is associated with increased severity of pneumonia. Children who died had low serum zinc levels, hypoxia, features suggestive of shock and radiological features of bilateral interstitial infiltrate. Serum zinc levels measured at the time of admission is a better predictor of mortality. When used in conjugation with other risk factors like young age, hypoxia, shock, serum zinc levels play a role in identifying sick child with pneumonia going for complication.