Febrile respiratory infections in children: assessment of clinical severity and cerebral vulnerability using the NGCS-RS scale

Bondarenko, Ya.D. and Kauk, O.I. and Riznychenko, O.K. and Cherkashyna, L.V. and Hovbakh, I.O. (2026) Febrile respiratory infections in children: assessment of clinical severity and cerebral vulnerability using the NGCS-RS scale. Медичні перспективи = Medicni perspektivi (Medical perspectives), Т. 31 (2). pp. 125-134. ISSN 2307-0404 (print), 2786-4804 (online)

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Abstract

Acute respiratory infections in children are accompanied by systemic inflammatory, metabolic, and microcirculatory disturbances that may affect the developing brain even without focal neurological symptoms. During critical neurodevelopmental stages, brain function depends on stable oxygenation, perfusion, and energy metabolism, increasing the vulnerability of the neuro-glio-capillary system to combined inflammatory and hypoxic stress. The aim of this study was to substantiate a systemic model of cerebral stability, identify threshold markers of its alteration, and develop the NeuroGlio-Capillary System Risk Score (NGCS-RS) for early detection of cerebral vulnerability. A retrospective-prospective study included 1,243 children aged 1 month to 18 years. Clinical and laboratory parameters were analyzed throughout the infection course. Inclusion criteria were confirmed viral or bacterial respiratory infections; children with chronic neurological, endocrine, or metabolic disorders were excluded. Participants were divided into viral infection, bacterial infection, and healthy control groups. Statistical validation involved correlation analysis and prognostic modeling. A critical threshold of alteration was identified: C-reactive protein ≥8 mg/L, body temperature ≥39°C, and oxygen saturation ≤90%. Risk scores differed significantly between groups, with the highest values in bacterial infections. Receiver operating characteristic analysis showed excellent accuracy (AUC 0.87). A cutoff of 10 points yielded 85.3% sensitivity and 83.7% specificity. Respiratory infections may be associated with threshold-dependent potential cerebral instability via neuro-glio-capillary dysregulation. The reference standard for validation comprised independent clinical outcomes not included in NGCS-RS scoring: ICU admission, hospital stay >7 days, and/or objective neurological complications. The revised AUC was 0.87 (95% CI: 0.82-0.92), with sensitivity 85.3% and specificity 83.7%, reflecting robust but clinically realistic discriminative performance. The proposed scale may be used for preliminary risk strat

Item Type:	Article
Additional Information:	doi: 10.26641/2307-0404.2026.2.365911
Uncontrolled Keywords:	Key words: neuro-glio-capillary system, cerebral stability, pediatric respiratory infections, systemic inflammation, neurovascular unit, astrocyte metabolism, cerebral vulnerability; нейрогліокапілярна система, церебральна стабільність, педіатричні респіраторні інфекції, системне запалення, нейроваскулярна одиниця, метаболізм астроцитів, церебральна вразливіст
Subjects:	Pediatrics
Divisions:	University periodicals > Medical perspectives
Depositing User:	Ирина Медведева
Date Deposited:	10 Sep 2026 09:12
Last Modified:	10 Sep 2026 09:12
URI:	http://repo.dma.dp.ua/id/eprint/10275

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