Influencing factors for severe pertussis among Chinese children: A meta-analysis.
Yingying Yang, Yaning Zhuo, Xinren Che et al.
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In 30 seconds
This meta-analysis examined factors associated with severe pertussis among children in China. Searches identified 24 studies, comprising 839 severe and 4,280 non-severe cases. The strongest reported association was for lung consolidation or atelectasis (OR: 15.44; 95%CI: 9.06-26.31). Other prominent associations included three concave sign, elevated C-reactive protein, and lack of DTP vaccination; white blood cell count was also higher in severe cases. These pooled findings identify clinical features and vaccination status associated with severity, but do not establish that the factors cause severe disease.
Key findings
- Lung consolidation or atelectasis had the strongest reported association with severe pertussis (OR: 15.44; 95%CI: 9.06-26.31).
- Three concave sign was associated with severe pertussis (OR: 12.91; 95%CI: 5.46-30.53).
- Elevated C-reactive protein (OR: 5.33; 95%CI: 3.00-9.49) and lack of DTP vaccination (OR: 4.00; 95%CI: 2.86-5.58) were associated with severity.
- White blood cell count was higher in severe cases (WMD: 16.42 × 10 9 /L; 95%CI: 9.49-23.36).
Why it matters
The pooled evidence highlights clinical signs, laboratory findings, imaging abnormalities, and vaccination status that may help identify children at risk of severe pertussis. Recognising these associations can inform assessment and prevention discussions, while the observational nature of the underlying evidence means they should not be interpreted as proof of causation.
What to keep in mind
The meta-analysis combines findings from 24 studies, and the abstract does not report study-level design or quality; pooled associations therefore do not establish causality.