What is it about?
Background. Acute respiratory infections (ARIs) in children are commonly accompa-nied by asthenovegetative symptoms, such as lethargy, irritability, and cardiovascular dysregulation. However, the underlying pathophysiological mechanisms remain insufficiently understood. Purpose – to examine the relationship between the intensity of systemic inflamma-tory response and neurological manifestations in pediatric ARIs, with a particular focus on neuro-glio-capillary dysfunction as a key pathophysiological link. Materials and Methods. A prospective clinical study was conducted involving 40 children aged 2–12 years, categorized into three groups: Group A (n=15) included children with uncomplicated viral respiratory infections and CRP levels of 1–7 mg/L; Group B (n=15) comprised children with confirmed bacterial respiratory infections and CRP ≥ 8 mg/L; Group C (n=10) served as a healthy control group with CRP < 1 mg/L. All participants underwent comprehensive neurological examination, measurement of vital parameters, pulse oximetry, and laboratory testing. Comparative statistical analysis of symptom frequency and severity between groups was performed using the Mann–Whitney U test. Results. Group A demonstrated predominantly functional and mild neurological symptoms, including lethargy (73%), mild tachycardia (40%), and increased tactile sensitivity (27%), with all children maintaining normal consciousness and oxygen saturation > 95%. In contrast, Group B showed significantly more pronounced mani-festations, including impaired consciousness (33%), oxygen desaturation down to 88–90% in 27% of patients, motor disturbances such as hypotonia and coordination disorders (20% each), and more severe autonomic signs (tachycardia in 80%). The average number of neurological symptoms per patient was significantly higher in Group B compared to Group A. A temperature threshold of approximately 39.0°C was identified, beyond which signs of neuro-glio-capillary decompensation occurred, particularly in bacterial infections. Dehydration, observed in 33% of Group B, was strongly associated with the most severe neurological manifestations. Conclusions. This study highlights neuro-glio-capillary dysfunction as a key mecha- nism in the development of asthenovegetative symptoms in pediatric ARIs. A clear correlation was established between systemic inflammation markers (CRP levels), oxygen saturation, febrile response, and the severity of neurological involvement. CRP levels exceeding 8 mg/L, hyperthermia >39.0°C, and oxygen saturation < 90% may serve as early predictors of significant neuro-glio-capillary impairment. These fin-dings underscore the importance of integrated clinical monitoring – including inflam-matory markers, oxygenation status, hydration, and neurological function – for early detection and prevention of potential complications in children with ARIs
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Why is it important?
Why do kids get so tired when they have a fever? Our new study shows that even mild infections can disrupt the brain’s neuro-glio-capillary network — linking fever, CRP, and oxygen levels to real neurological fatigue.
Perspectives
Considering the demonstrated clinical significance of neuro-glio-capillary dysfunction as a key pathophysiological mechanism in the development of asthenovegetative symptoms in children with acute respiratory infections, further in-depth studies in this area are warranted. Primarily, expanding the clinical sample to include a larger number of patients across different age groups would be promising, allowing an objective assessment of age-related susceptibility to neuroinflammation and hypoxic injury. It is also important to involve patients with more severe disease courses and various infectious etiologies viral, bacterial, and mixed for a comparative analysis of the extent of neurological changes. Future studies should include longitudinal monitoring of the neurological and cognitive status of children in the post-infectious period to identify potential long-term consequences of transient neuro-glio-capillary dysfunction. Special attention should be paid to studying biochemical and molecular markers of neuroinflam-mation (including levels of interleukins IL-6, IL-1β, TNF-α, proteins S100B, NSE), which may complement clinical and laboratory parameters and enable early identification of at-risk conditions. Additionally, the development of a standardized risk assessment scale for neurovegetative disorders in children with acute respiratory infections at the outpatient stage is promising. This would facilitate the implementation of routine neurological screening in pediatric clinical practice, allowing timely detection of latent or mild forms of neurofunctional disorders that are currently underestimated. The development and validation of such tools could enhance the effectiveness of preventing neurological complications and contribute to improving the quality of medical care for children with systemic inflammatory responses during infectious processes.
Yaroslav Bondarenko
Friedrich-Alexander-Universitat Erlangen-Nurnberg
Read the Original
This page is a summary of: Neuro-glio-capillary dysfunction in children with respiratory infections: early clinical markers and the role of outpatient screening, Psychiatry Neurology and Medical Psychology, August 2025, V. N. Karazin Kharkiv National University,
DOI: 10.26565/2312-5675-2025-30-03.
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