Immunophysiological profile of non-COVID-19 pneumonia: a cross-sectional, multi-center study between artificially fed and breastfed children

Background
Pneumonia is a substantial public health concern and is the principal source of ailment and death in children below the age of five. Mortality remains high in several countries even though infant pneumonia-related deaths have declined over the past decade.

Objectives
This study was designed to detect the immunological profile of pediatric pneumonia among various feeding methods.

Material and methods
This investigation was a cross-sectional, multi-center study that recruited 190 applicants, divided on the forms of received feeding into three groups: 97 were on artificial feeding, 13 were on mixed feeding, and the remaining 80 were breastfed. The ages of the applicants were up to 30 months. Hematological samples were obtained to assess leukocyte count, in addition to immunologic assays of IL-5, CRP, TLR2, IgA, TLR4, and IgE measures, along with samples to determine the etiology of pneumonia.

Results
Most of the pneumonia cases arose within the earlier months of life with a mean ± SD of 9.8 ± 10.2, and they revealed an equal gender distribution. Breastfeeding was observed among 42.1% of children. The levels of the studied immunoassays and their multiple post-hoc analysis, in the majority of the cases, exhibited a significant alteration among the three groups of feeding (p < 0.05). Mean-while, there were no considerable differences in most of the measured variables based on the etiology of pneumonia. Similarly, non-significant correlations were observed in the age of the infants with all investigated immune factors. According to the ROC-curve examination, all the studied immunology pointers had non-significant predictive power to distinguish between those artificially fed and those breastfed.

Conclusions
The study demonstrated a promising correlation between the immune profile and feeding among infants with pneumonia. Hence, breastfeeding must be encouraged globally as an adjunct and preventive measure, together with new maternal vaccination schedules.