Evaluative Value of Serum TNFSF14，TLR7，and sCD14-ST Levels in Assessing Disease Severity and Prognosis of Respiratory Syncytial Virus Infection-Related Pneumonia in Children

Xiaowei LI; Kai YANG; Fanrong WANG; Xu LIU

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Xiaowei LI, Kai YANG, Fanrong WANG, Xu LIU. Evaluative Value of Serum TNFSF14，TLR7，and sCD14-ST Levels in Assessing Disease Severity and Prognosis of Respiratory Syncytial Virus Infection-Related Pneumonia in Children[J]. Journal of Kunming Medical University.

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Evaluative Value of Serum TNFSF14，TLR7，and sCD14-ST Levels in Assessing Disease Severity and Prognosis of Respiratory Syncytial Virus Infection-Related Pneumonia in Children

Department of Paediatrics，Qingdao Jiaozhou Central Hospital，Qingdao Shandong 266300，China

Received Date: 2025-09-03

Abstract

Abstract

Objective To investigate the significance of serum tumor necrosis factor superfamily member 14 （TNFSF14）, toll-like receptor 7 （TLR7）, and soluble cluster of differentiation 14 subtype （sCD14-ST） levels in evaluating disease severity and prognosis in children with pneumonia associated with respiratory syncytial virus （RSV） infection. Methods A total of 154 children with RSV infection-related pneumonia admitted between July 2024 and July 2025 were enrolled as the disease group, classified into mild group （n = 52） and severe group （n = 102） based on disease severity. Simultaneously, 154 healthy children who underwent routine physical examinations at our hospital served as the control group. Serum levels of TNFSF14, TLR7, and sCD14-ST were measured using ELISA. According to prognosis, patients were divided into poor prognosis group （n = 35） and good prognosis group （n = 119）. ROC curve analysis was performed to evaluate the value of serum TNFSF14, TLR7, and sCD14-ST levels in assessing disease severity and prognosis in children with RSV infection-related pneumonia. Multivariate Logistic regression analysis was used to identify independent factors affecting poor prognosis. Results Serum levels of TNFSF14, TLR7, and sCD14-ST in the disease group were significantly higher than in the control group （P < 0.05）. Compared with the mild group, children in the severe group showed significantly elevated serum levels of TNFSF14, TLR7, and sCD14-ST （P < 0.05）. Spearman rank correlation analysis demonstrated that serum levels of TNFSF14, TLR7, and sCD14-ST showed significant positive correlations with chest X-ray （CXR） lesion extent grade at admission （all P <0.001）, with TNFSF14 showing the strongest correlation （r_s = 0.484） followed by TLR7 （r_s = 0.421） and sCD14-ST （r_s = 0.349）. Stratified analysis showed that in the severe group, the correlations between all three markers and lesion extent grade （TNFSF14: r_s = 0.525, TLR7: r_s = 0.493, sCD14-ST: r_s = 0.424; All P <0.001） were significantly stronger than in the mild group （TNFSF14: r_s = 0.31, TLR7: r_s = 0.27, sCD14-ST: r_s = 0.24; all P <0.05）. Compared with single marker detection, combined measurement of serum TNFSF14 （Z = 4.884, P < 0.001）, TLR7 （Z = 2.792, P = 0.003）, and sCD14-ST （Z = 4.803, P < 0.001） levels had a higher evaluation value for disease severity in children with RSV infection-related pneumonia. Significant differences were observed between the poor and good prognosis groups in lesion extent grade, lesion type, and presence of complications （P < 0.05）. Compared with the good prognosis group, the poor prognosis group showed significantly elevated serum levels of TNFSF14, TLR7, and sCD14-ST （P < 0.05）. Compared with individual detection, the combined detection of serum TNFSF14 （Z = 3.902, P < 0.001）, TLR7 （Z = 3.434, P < 0.001）, and sCD14-ST （Z = 2.394, P = 0.017） levels had a higher prognostic value for children with RSV pneumonia. Multivariate logistic regression analysis revealed that serum levels of TNFSF14 （OR = 4.351）, TLR7 （OR = 2.635）, sCD14-ST （OR = 1.695）, diffuse infiltration （OR = 4.121）, and presence of complications （OR = 3.570） were independent factors affecting poor prognosis in children with RSV infection-related pneumonia （P < 0.05）. Conclusion Serum levels of TNFSF14, TLR7, and sCD14-ST are significantly elevated in children with RSV infection-related pneumonia. Combined detection of these three markers enhances the evaluation value for assessing disease severity and prognosis.

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References(22)

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