Multisystem inflammatory syndrome associated with SARS-CoV-2 infection in children: update and new insights from the second report of an Iranian referral hospital

Mamishi, Setareh; Olfat, Mehrnaz; Pourakbari, Babak; Eshaghi, Hamid; Abdolsalehi, Mohammad Reza; Shahbabaie, Mohammad Ali; Jalali, Fatemeh; Safari, Fatemeh; Mahmoudi, Shima

doi:10.1017/s0950268822001522

Cited by 10 publications

(8 citation statements)

References 31 publications

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“…The deficit of 25-OH vitamin D is a major health issue; it is estimated that over a billion people worldwide lack 25-OH vitamin D [ 14 ]. Although there were few studies in the beginning, a link between symptomatology, severity and outcome in COVID-19 with regard to 25-OH vitamin D has been observed [ 15 , 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 Biomarkers Comparison: Children, Adults and Elders

et al. 2023

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Background and Objectives: this study aimed to research links between C-reactive protein (CRP), lactate dehydrogenase (LDH), creatinekinase (CK), 25-OH vitamin D (25-OHD), ferritin (FER), high-density lipoprotein cholesterol (HDL)cholesterol and clinical severity in patients from the western part of Romania, and compare their potential use as biomarkers for intensive care units (ICU) admission and death in children, adults and elders. Materials and Methods: this study is a retrospective cohort study, performed on patients positively diagnosed with COVID-19. Available CRP, LDH, CK 25-OH vitamin D, ferritin, HDL cholesterol and clinical severity were recorded. The following were assessed: median group differences, association, correlation and receiver operating characteristic. Results: 381 children, 614 adults and 381 elders were studied between 1 March 2021 and 1 March 2022. Most children and adults presented mild symptomatology (53.28%, 35.02%, respectively), while most elders presented severe symptomatology (30.04%). ICU admission was 3.67% for children, 13.19% for adults and 46.09% for elders, while mortality was 0.79% for children, 8.63% for adults and 25.1% for elders. With the exception of CK, all other biomarkers showed some significant associations with clinical severity, ICU admission and death. Conclusions: CRP, LDH, 25-OH vitamin D, ferritin and HDL are important biomarkers for COVID-19 positive patients, especially in the pediatric population, while CK was mostly within normal ranges.

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Section: Introductionmentioning

confidence: 99%

COVID-19 Biomarkers Comparison: Children, Adults and Elders

et al. 2023

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“…In the study by Torpoco Rivera et al ( 20 ), the authors found that the seriousness of MIS-C, especially cardiac involvement, was associated with severe vitamin D deficiency [25 (OH) vitamin D level <10 ng/mL]. In the study conducted by Mamishi et al ( 21 ), 122 patients with MIS-C were divided into two groups (mild-moderate and severe). Mild-to-moderate MIS-C was present in 97, while severe MIS-C was present in 25.…”

Section: Discussionmentioning

confidence: 99%

Can Serum 25-Hydroxy Vitamin D Levels Predict the Severity of Multisystem Inflammatory Syndrome in Children and COVID-19?

Keleş¹,

Yilmaz²,

Taşar³

et al. 2023

Jcrpe

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Objective: To determine the clinical significance of serum 25-hydroxy (OH) vitamin D levels in pediatric patients with multisystem inflammatory syndrome in children (MIS-C) and compare the vitamin D levels of these patients with those patients with Coronavirus disease-2019 (COVID-19) and healthy controls. Methods: This study was designed for pediatric patients aged 1 month to 18 years and conducted between July 14 and December 25, 2021. Fifty-one patients with MIS-C, 57 who were hospitalized with COVID-19, and 60 controls were enrolled in the study. Vitamin D insufficiency was defined as a serum 25 (OH) vitamin D level of less than 20 ng/mL. Severe MIS-C was classified as necessitating intensive care due to cardiovascular instability, the necessity for non-invasive or invasive mechanical ventilation, and/or a diminishing Glasgow coma scale. World Health Organization definition criteria were used to describe the clinical stages of COVID-19 in children and patients were divided into four groups according to the clinical severity of COVID-19: asymptomatic, mild, moderate, and severe/critical. Results: The median serum 25 (OH) vitamin D was 14.6 ng/mL in patients with MIS-C, 16 ng/mL in patients with COVID-19, and 21.1 ng/mL in the control group (p<0.001). Vitamin D insufficiency was present in 74.5% (n=38) of patients with MIS-C, 66.7% (n=38) of patients with COVID-19, and 41.7% (n=25) of the controls (p=0.001). The percentage of four or more affected organ systems was 39.2% in patients with MIS-C. The correlation between the number of affected organ systems and serum 25 (OH) vitamin D levels was evaluated in patients with MIS-C and there was a moderate negative correlation (r=-0.310; p=0.027). A weak negative correlation was found between the severity of COVID-19 and serum 25 (OH) vitamin D (r=-0.320, p=0.015). Conclusion: Vitamin D levels were insufficient in both the MIS-C and COVID groups. Furthermore, vitamin D levels correlated with the number of affected organ systems in MIS-C and the severity of COVID-19.

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“…In adults, there are many therapeutic approaches, which include agents with direct action such as antivirals (remdesivir, favipiravir, lopinavir/ritonavir, molnupiravir, nirmatrelvir/ritonavir, simeprevir), antimalarials (chloroquine, hydroxychloroquine), antibiotics (azithromycin), or with supportive action, such as interleukin inhibitors (anakinra, tocilizumab), Janus kinase inhibitors (baricitinib), corticotherapy (dexamethasone), anticoagulants (low molecular weight heparin) and non-steroid anti-inflammatory drugs. Information about treatment options for children is somewhat scarce, however it is known that remdesevir and nirmatrelvir/ritonavir were approved for use, while the use of lopinavir/ritonavir was discouraged in pediatric patients [ 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

COVID-19 Inflammatory Markers and Vitamin D Relationship in Pediatric Patients

Bagiu

Scurtu

Horhat

et al. 2022

Life

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Background: Biomarkers play an important role in COVID-19, and more research in this regard is needed, especially in the case of children. This study aimed to look for a link between the C reactive protein (CRP), lactate dehydrogenase (LDH), creatine kinase (CK), vitamin D and COVID-19 in pediatric patients. Methods: This is a retrospective cohort study, performed on children diagnosed positively with COVID-19 at a children’s hospital in western Romania. Available CRP, LDH, CK vitamin D and clinical severity were recorded. For each biomarker, groups were formed by patients’ age. Mean/median group differences were assessed using Student’s t test or Mann–Whitney and Kruskal–Wallis with Dunn’s post hoc tests. Association was assessed using the chi2 test, while correlation was assessed using Spearman’s rank correlation. Results: 181 positive children were studied between 1 August 2021 and 1 February 2022. Average age was 8.76 years (SD = 3.93). There were 94 (51.93%) males and 87 (48.07%) females. The cases were: 62 asymptomatic (34.25%), 107 mild (59.12%), 9 moderate (4.97%), 3 severe (1.66%). Regarding CRP, a significant difference between older and younger patients was observed (p = 0.0034). Clinical severity was associated with CRP (p = 0.0281), LDH (p = 0.0410) and vitamin D (p = 0.0444). Regarding CK, no differences or associations proved significant. Correlation testing was conducted for CRP, LDH, vitamin D and clinical signs. With the exception of LDH-CRP and LDH-vitamin D, all relationships proved statistically significant. Conclusions: CRP, LDH and vitamin D levels are important biomarkers for COVID-19-positive pediatric patients, while CK was mostly within normal ranges.

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Multisystem inflammatory syndrome associated with SARS-CoV-2 infection in children: update and new insights from the second report of an Iranian referral hospital

Abstract: Introduction: Here, we are sharing our second report about children affected by Multisystem Inflammatory Syndrome in Children (MIS-C). The aim of the present study was to update our knowledge about children with MIS-C. Furthermore, we tried to compare clinical manifestations,

Cited by 10 publications

References 31 publications

COVID-19 Biomarkers Comparison: Children, Adults and Elders

COVID-19 Biomarkers Comparison: Children, Adults and Elders

Can Serum 25-Hydroxy Vitamin D Levels Predict the Severity of Multisystem Inflammatory Syndrome in Children and COVID-19?

COVID-19 Inflammatory Markers and Vitamin D Relationship in Pediatric Patients

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