Pediatric patients with COVID-19 admitted to intensive care units in Brazil: a prospective multicenter study

Prata‐Barbosa, Arnaldo; Lima‐Setta, Fernanda; Santos, Gustavo Rodrigues dos; Lanziotti, Vanessa Soares; Castro, Roberta Esteves Vieira de; Souza, Daniela Carla de; Raymundo, Carlos Eduardo; Oliveira, Felipe Rezende Caino de; Lima, Lúcio Flávio Peixoto de; Tonial, Cristian Tedesco; Colleti, José; Bellinat, Ana Paula Novaes; Lorenzo, Vivian Botelho; Zeitel, Raquel de Seixas; Pulcheri, Lucas; Costa, Fernanda Ciuffo Monte da; Torre, Fabíola Peixoto Ferreira La; Figueiredo, Elaine Augusta das Neves; Silva, Thiago Peres da; Riveiro, Paula Marins; Mota, Isabele Coelho Fonseca da; Brandão, Igor Bromonschenkel; Azevedo, Zina Maria Almeida de; Gregory, Simone Camera; Boedo, Fernanda Raquel Oliveira; Carvalho, Rosana Novais de; Castro, Natália Almeida de Arnaldo Silva Rodriguez; Genu, Daniel Hilário Santos; Foronda, Flávia Andrea Krepel; Cunha, Antônio José Lêdo Alves da; Magalhães‐Barbosa, Maria Clara de

doi:10.1016/j.jped.2020.07.002

Cited by 71 publications

(94 citation statements)

References 22 publications

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“…Of these, 2055 duplicate studies were removed; 1663 studies were excluded after title and abstract screening, and 202 were excluded following full text screening based on the set inclusion criteria. Twenty-four studies [ [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] ] were ultimately included in the meta-analysis ( Fig. 1 ).…”

Section: Resultsmentioning

confidence: 99%

Cardiac markers of multisystem inflammatory syndrome in children (MIS-C) in COVID-19 patients: A meta-analysis

Zhao

Patel

Huang

et al. 2021

The American Journal of Emergency Medicine

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Objective A meta-analysis of laboratory cardiac markers for multisystem inflammatory syndrome in children (MIS-C) was performed in patients with coronavirus disease 2019 (COVID-19). Methods Eight databases were searched until April 10, 2021, for studies on cardiac markers, including B-type natriuretic peptide (BNP)/N-terminal pro-BNP (NT-proBNP), troponin, aspartate aminotransferase (AST), in MIS-C patients. Results Of the 2583 participants enrolled in 24 studies, 1613 patients were diagnosed with MIS-C. MIS-C patients exhibited higher BNP levels than patients with non-severe COVID-19 [SMD ( 95% CI ): 1.13 (0.48, 1.77), p < 0.05]. No significant differences in BNP levels were observed between patients with MIS-C and severe COVID-19 [SMD ( 95% CI ): 0.29 (−0.07, 0.65), p = 0.117]. Comparisons of MIS-C patients to all COVID-19 patients revealed no significant differences in levels of troponin [SMD ( 95% CI ): 0.13 (−0.07, 0.32), p = 0.212] or AST [SMD ( 95% CI ): 0.10 (−0.11, 0.31), p = 0.336]. Compared to patients with non-severe MIS-C, those with severe MIS-C exhibited higher levels of BNP [SMD ( 95% CI ): 0.26 (0.04, 0.48), p < 0.05], but no differences in troponin [SMD ( 95% CI ): 0.05 (−0.06, 0.16) p = 0.387] or AST [SMD ( 95% CI ): 0.19 (−0.34, 0.71), p = 0.483] were observed. Moreover, there was no significant difference in BNP [SMD ( 95% CI ): −0.21 (−1.07, 0.64), p = 0.624] or troponin [SMD ( 95% CI ): −0.07 (−0.45, 0.31), p = 0.710] between MIS-C with and without coronary artery abnormality. Sensitivity analyses were performed to assess stability. No publication bias was detected based on Begg's test. Conclusions The key cardiac marker that showed differences between patients with MIS-C/non-severe COVID-19 and between patients with severe/non-severe MIS-C was BNP. Other markers, such as troponin and AST, did not exhibit notable differences in indicating cardiac injury between patients with MIS-C and COVID-19.

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Section: Resultsmentioning

confidence: 99%

Cardiac markers of multisystem inflammatory syndrome in children (MIS-C) in COVID-19 patients: A meta-analysis

Zhao

Patel

Huang

et al. 2021

The American Journal of Emergency Medicine

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“…Overall, laboratory abnormalities are uncommon in children and are predominantly confined to children with severe disease and MIS-C (64)(65)(66)(67).…”

Section: Studies 3396 Patientsmentioning

confidence: 99%

Biomarkers in COVID-19: An Up-To-Date Review

2021

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The ongoing pandemic of coronavirus disease 2019 (COVID-19) poses several challenges to clinicians. Timely diagnosis and hospitalization, risk stratification, effective utilization of intensive care services, selection of appropriate therapies, monitoring and timely discharge are essential to save the maximum number of lives. Clinical assessment is indispensable, but laboratory markers, or biomarkers, can provide additional, objective information which can significantly impact these components of patient care. COVID-19 is not a localized respiratory infection but a multisystem disease caused by a diffuse systemic process involving a complex interplay of the immunological, inflammatory and coagulative cascades. The understanding of what the virus does to the body and how the body reacts to it has uncovered a gamut of potential biomarkers. This review discusses the different classes of biomarkers – immunological, inflammatory, coagulation, hematological, cardiac, biochemical and miscellaneous – in terms of their pathophysiological basis followed by the current evidence. Differences between children and adults are highlighted. The role of biomarkers in the diagnosis and management of Multisystem Inflammatory Syndrome in Children (MIS-C) is reviewed. The correlation of biomarkers with clinical and radiological features and the viral load, temporal evolution and the effect of treatment remain to be studied in detail. Which biomarker needs to be evaluated when and in whom, and how best this information can contribute to patient care are questions which currently lack convincing answers. With the evidence currently available broad guidelines on the rational use of available biomarkers are presented. Integrating clinical and laboratory data, monitoring trends rather than a single value, correlating with the natural course of the disease and tailoring guidelines to the individual patient and healthcare setting are essential.

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“…Few publications on COVID-19 in children ( 11 ) and MIS-C ( 12 ) have reviewed cases in Latin America. We describe the clinical characteristics, treatment, and results of a cohort of children admitted to the pediatric intensive care unit (PICU) with MIS-C in a tertiary hospital in Chile.…”

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confidence: 99%