This study aims to identify the clinical factors that predict the severity of community-acquired pneumonia (CAP) in pediatric patients. Children admitted to Assiut University Children's Hospital with a diagnosis of CAP will be evaluated through clinical examination, vital signs, laboratory investigations, and radiological findings. The study focuses on determining which clinical features are associated with more severe disease, higher need for oxygen therapy, intensive care admission, or complications. Understanding these predictors may help clinicians recognize severe cases earlier and improve patient management and outcomes.

Community-acquired pneumonia (CAP) is one of the most common causes of morbidity and hospitalization among children worldwide. Early recognition of severe cases is essential for timely intervention. However, clinical predictors of severity in pediatric CAP vary across populations, and there is a need for locally applicable evidence to guide clinical decision-making.

This observational cross-sectional study will enroll pediatric patients presenting with community-acquired pneumonia to Assiut University Children's Hospital. The diagnosis of CAP will be established based on clinical assessment and radiological confirmation. For each patient, demographic data, presenting symptoms, physical examination findings, vital signs, laboratory investigations, and radiological features will be recorded systematically according to the study protocol.

The primary objective of this study is to identify the clinical and laboratory predictors that are significantly associated with severe pneumonia. Severity will be assessed based on predefined criteria, including oxygen requirement, respiratory distress indicators, complications, and need for intensive care admission. Secondary objectives include describing the distribution of severity levels among the enrolled patients and assessing the relationship between individual risk factors and disease outcomes.

The results of this study are expected to provide clinically relevant predictors that can support early identification of severe CAP in children, improve triage decisions, and optimize treatment strategies within similar healthcare settings.

Inclusion Criteria:

• Children aged 1 month to 5 years.
• Children of both sexes
• Onset of illness in the community, not more than 48 hours after hospital admission.

Exclusion Criteria:

• Children below 1 month, as neonatal pneumonia differs in pathology and management from CAP.
• Children with hospital-acquired pneumonia
• Known primary or secondary immunodeficiency
• Children with chronic respiratory diseases (as cystic fibrosis, bronchiectasis) or congenital lung malformations.

Children aged 1 month to 5 years of both sexes diagnosed with community-acquired pneumonia (CAP) presenting to the pediatric emergency department or admitted to pediatric wards at Assiut University Children's Hospital during the study period (October 2025 - October 2026). Children with hospital-acquired pneumonia, known immunodeficiency, chronic respiratory diseases, or congenital lung malformations are excluded.