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Record W4411831267 · doi:10.4081/monaldi.2025.3564

Biomarkers in atypical pneumonia: a systematic review of diagnostic and prognostic utility

2025· review· en· W4411831267 on OpenAlex
Debashis Priyadarshan Sahoo, Bikash Ranjan Rout

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

aboutThe title or abstract carries a Canadian signal from the geographic lexicon.
no affNo Canadian affiliation: this work is invisible to an affiliation-only frame.
No Canadian affiliation. An affiliation-only frame, the usual design, would never have seen this work. It is one of the works that make the case for inverting the frame.

Bibliographic record

VenueMonaldi Archives for Chest Disease · 2025
Typereview
Languageen
FieldMedicine
TopicPneumonia and Respiratory Infections
Canadian institutionsnot available
Fundersnot available
KeywordsProcalcitoninMedicineMycoplasma pneumoniaeInternal medicineMycoplasma pneumoniaBiomarkerPneumoniaChlamydiaConfidence intervalAtypical pneumoniaMycoplasmaOdds ratioGastroenterologyChlamydophila pneumoniaeFerritinImmunologySepsisMicrobiologyBiology

Abstract

fetched live from OpenAlex

Atypical pneumonia, driven by pathogens like Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella pneumophila, is challenging to diagnose due to non-specific symptoms. This systematic review assessed the diagnostic accuracy and prognostic value of biomarkers in atypical pneumonia. A comprehensive search of PubMed, Scopus, Web of Science, and Google Scholar (2000-2024) identified 27 studies, including observational, cohort, case-control, and review designs. Studies focused on biomarkers such as C-reactive protein (CRP), procalcitonin (PCT), ferritin, D-dimer, and pathogen-specific antibodies, with quality evaluated using the Newcastle-Ottawa Scale and AMSTAR 2. CRP was elevated in 85% of cases, with a pooled sensitivity of 82.3% [95% confidence interval (CI) 76.5-88.1, I²=78%] but moderate specificity (65.2%, 95% CI 58.0-72.4). PCT exhibited high specificity (88.7%, 95% CI 83.2-94.2, I²=65%) for bacterial etiologies, making it valuable for distinguishing bacterial from viral infections. Anti-Mycoplasma pneumoniae immunoglobulin M (IgM) showed excellent diagnostic accuracy (sensitivity 90.1%, 95% CI 85.0-95.2). Ferritin levels >400 ng/mL were strongly associated with severe outcomes [odds ratio (OR) 3.15, 95% CI 2.10-4.72, I²=70%]. Elevated biomarkers correlated with increased hospitalization (OR 2.78, 95% CI 1.95-3.96) and mortality (OR 3.42, 95% CI 2.30-5.08). Heterogeneity was significant (I²=65-78%), reflecting variability in study populations and methods. PCT and anti-Mycoplasma pneumoniae IgM enhance diagnostic precision, while ferritin and CRP are robust prognostic markers. Standardized biomarker thresholds are essential to optimize their clinical utility and improve patient outcomes in atypical pneumonia management.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.012
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMetaresearch, Meta-epidemiology (narrow)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Systematic review · Consensus signal: Systematic review
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.027
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.012
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0030.001
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.025
GPT teacher head0.334
Teacher spread0.309 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it