Incidence, Associated Factors, and Prognosis of Liver Dysfunction in Children with Community-Acquired Pneumonia: A Multicenter Prospective Study

Objective Community-acquired pneumonia with abnormal liver function is not uncommon. There is no systematic study on the clinical characteristics of liver dysfunction in children with community-acquired pneumonia. We aimed to evaluate the characteristics and prognosis of liver dysfunction in children with community-acquired pneumonia.

Methods This study was a multicenter prospective study involving 26 hospitals in Sichuan Province from June 2020 to June 2021. The characteristics of liver dysfunction in children with community-acquired pneumonia were recorded and analyzed according to different factors such as age, medical condition, level of transaminase in liver function, and time for liver function recovery.

Results A total of 4,623 hospitalized children with pneumonia were included. Among them, 592 children had liver dysfunction, accounting for the 12.8% (592/4,623). The degree of liver function injury was more obvious in infants and in children of severe pneumonia group (average ranks were 288.95 and 319.34). The liver lesion was more serious in the group of children less than 1 year old (p = 0.000). The median time to recovery of liver function was 8 days (interquartile range: 6–15.5 days), whereas the fastest recovery was 3 days, and the longest recovery period was 162 days.

Conclusion Community-acquired pneumonia with abnormal liver function is very common. Young age and severe pneumonia are risk factors for liver dysfunction. The recovery time of liver enzymes is not short. Infants and children with severe pneumonia need closer follow-up.