Predictive value of cardiac markers in the prognosis of COVID-19 in children

Güllü, Ufuk Utku; Güngör, Şükrü; İpek, Sevcan; Yurttutan, Sadık; Dilber, Cengiz

doi:10.1016/j.ajem.2021.06.075

Cited by 22 publications

(21 citation statements)

References 23 publications

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“…COVID-19 presents primarily with pulmonary disease; however, especially in adults, a significant portion of patients have cardiac involvement [ 2 – 4 ]. Like adults, children can have cardiac involvements such as arrhythmia, myocarditis, and cardiogenic shock with MIS-C associated with SARS-CoV-2 infection [ 7 , 8 ]. The pathogenesis of the cardiac damage of COVID-19 is not clear in children.…”

Section: Discussionmentioning

confidence: 99%

“…Güllü et al [ 8 ] evaluated 320 pediatric patients, and five were diagnosed with MIS-C. They reported that cardiac markers (NT-proBNP and troponin I), especially NT-proBNP, could be used to detect early diagnosis of cardiac involvement and/or MIS-C in pediatric patients with COVID-19.…”

Section: Discussionmentioning

confidence: 99%

“…However, COVID-19 rarely can cause cardiac disorders in children during acute infection or the resulting multisystem inflammatory syndrome in children (MIS-C) [ 7 ]. There are limited studies in the literature on the use of troponin levels and the potential role in predicting the cardiac involvement of COVID-19 in children [ 8 – 10 ]. In addition, when to have a consultation for a cardiology specialist is not clear, and the previous studies reported an increased workload of the pediatric cardiology department [ 11 – 13 ].…”

Section: Introductionmentioning

confidence: 99%

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The Evaluation of Troponin I Levels and Myocarditis in Children with COVID-19: A Pediatric Single-Center Experience

et al. 2022

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Children with COVID-19 usually show milder symptoms than adults; however, a minority of them may have cardiac involvement. We aimed to identify the role of troponin I levels that may predict early cardiac involvement in children with COVID-19. A single-center retrospective study was conducted to evaluate hospitalized children diagnosed with COVID-19 between March 11, 2020, and December 31, 2021. Patients with available troponin I levels and with no known cardiac disease were included. During the study period, 412 children with COVID-19 who had troponin I levels on admission were identified. Troponin levels were elevated in 7 (1.7%) patients and were normal in 395 (98.3%) patients. The median age of patients with elevated troponin levels was 4 (min. 2–max. 144) months, which was statistically lower than the age of patients with normal troponin levels ( P = 0.035). All the patients with elevated troponin levels had tachycardia. Out of 7 patients with high troponin levels, 3 (42.9%) of them were admitted to the pediatric intensive care unit (PICU), 2 (28.6%) required oxygen support, and 1 (14.3%) required a mechanical ventilator. Patients with elevated troponin levels had a statistically longer hospital stay ( P < 0.001). Neutropenia, tachycardia, PICU admission, oxygen support, and mechanical ventilation were statistically more common in patients with elevated troponin levels ( P values were 0.033, 0.020, < 0.001, 0.050, and < 0.001, respectively). Electrocardiography (ECG) and echocardiography (ECHO) were performed on all patients with elevated troponin levels, and 6 (85.8%) patients were diagnosed with myocarditis. The ECG and ECHO have been performed in 58 (14.3%) out of 405 patients with normal troponin levels. Two (3.5%) patients had negative T waves on ECG, and all ECHOs were normal. Our results suggest that elevated troponin I levels in children with COVID-19 can be used to evaluate cardiac involvement and decide the need for further pediatric cardiologist evaluation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Evaluation of Troponin I Levels and Myocarditis in Children with COVID-19: A Pediatric Single-Center Experience

et al. 2022

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“…Troponin is a protein released into the bloodstream following cell damage and is used as a marker of myocardial damage due to its cardiac specificity. Elevated troponin was also found to be associated with severe illness and poor prognosis for pediatric COVID-19 and MIS-C. 24,25 Based on this information, although we detected no cardiac dysfunction in our own patient group in clinical examination or echocardiography, we accepted troponin elevation as a marker of cardiac involvement. Therefore, we compared RDW in patients with and without troponin elevation and our statistical evaluation revealed a positive correlation between high RDW and elevated troponin levels.…”

Section: Resultsmentioning

confidence: 55%

Could red cell distribution width be used for predicting cardiac injury in neonates with COVID‐19?

Şimşek¹,

Ceran²,

Akin³

et al. 2022

Journal of Medical Virology

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Background Coronavirus disease 2019 (COVID‐19) can affect people of all age groups and it can occasionally cause life‐threatening clinical illnesses in immunologically immature populations, especially in newborns. High red cell distribution width (RDW) values were used as an early prognostic biomarker of some neonatal diseases. We aimed to determine the prognostic value of RDW in severe acute respiratory syndrome‐coronavirus‐2 (SARS‐CoV‐2) infected neonates. Methods Newborns with positive SARS‐CoV‐2 polymerase chain reaction (PCR) test from a nasopharyngeal swab sample, who had refractory fever (>38°C and lasting more than 24 h during hospitalization), were screened for multisystem inflammatory syndrome in newborns (MIS‐N), systemic inflammatory indexes calculated and cardiologic evaluations. Due to troponin levels (high: >45 ng/L and low: ≤45 ng/L) patients were grouped. Results Out of the 68 SARS‐CoV‐2 PCR‐positive newborns, 26 patients had refractory fever. Comparison of laboratory findings between the high and low‐troponin groups showed that RDW and neutrophil/lymphocyte ratio values were significantly higher in patients with high troponin levels ( p = 0.022 and p = 0.030, respectively). The cut‐off values with optimal sensitivity and specificity were determined as 1.00 for neutrophil/lymphocyte ratio ( p = 0.205) and 16.6 for RDW ( p = 0.014). None of the patients died. Conclusions Neonatal COVID‐19 generally has a benign prognosis, but can progress to severe disease and cases of MIS‐N are rare. RDW could be prognostic in the diagnosis and management of neonates with SARS‐CoV‐2 infection with high troponin levels.

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“…Recently, studies with brain natriuretic peptide (BNP) have started to gain importance in terms of human physiology [ 4 ]. BNP is widely used as a biomarker in heart diseases.…”

Section: Introductionmentioning

confidence: 99%

Snakebites in Pediatric Patients in Kahramanmaraş: Is Pro-brain Natriuretic Peptide a Prognostic Biomarker for Snakebites?

İpek¹,

Güngör²,

Güllü³

et al. 2022

Cureus

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Background: Snake envenomations are a serious cause of mortality and morbidity in the world.Aims: This study was conducted to investigate snake bites in pediatric patients in Kahramanmaraş and to determine whether pro-brain natriuretic peptide (proBNP) has a prognostic value in these patients.Methods: Pediatric patients aged <18 years who presented to the pediatric emergency department with snakebites were reviewed retrospectively. The demographical, clinical, laboratory, treatments, and outcomes data were collected from their medical records. Stage 0 and 1 envenomation was considered as a non-serious complication and stage 2 and 3 envenomation was considered as a serious complication.Results: A total of 32 pediatric patients, six females and 26 males, between 2016 and 2021, were included in the study. The mean age was 12.52±3.28 years. There were seven patients without serious complications and 25 patients with serious complications. The best cutoff point for proBNP to predict serious complications was found to be ≥272.5 ng•L -1 (sensitivity, 83.3%; specificity, 100%, p=0.011). We also detected complex regional pain syndrome in one of our patients.Conclusions: In this study, proBNP was shown to be predictive of a poor outcome of snakebites. Moreover, complex regional pain syndrome, which is rarely reported in the literature, should be kept in mind during the long-term follow-up of snakebites.

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Predictive value of cardiac markers in the prognosis of COVID-19 in children

Cited by 22 publications

References 23 publications

The Evaluation of Troponin I Levels and Myocarditis in Children with COVID-19: A Pediatric Single-Center Experience

The Evaluation of Troponin I Levels and Myocarditis in Children with COVID-19: A Pediatric Single-Center Experience

Could red cell distribution width be used for predicting cardiac injury in neonates with COVID‐19?

Snakebites in Pediatric Patients in Kahramanmaraş: Is Pro-brain Natriuretic Peptide a Prognostic Biomarker for Snakebites?

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