Hematological Parameters and Inflammatory Markers in Children with Multisystem Inflammatory Syndrome
Öz
Abstract
Objective:
Multisystem inflammatory syndrome in children (MIS-C), is a newly recognised life-threatening complication of coronavirus disease 2019 (COVID-19). Early determination of clinical severity of the disease is important for early decision of treatment regimens. The aim of this study is to investigate the severity classification value of a number of hematological parameters, inflammatory markers and biochemical tests in patients with MIS-C during the acute stage and after anti-inflammatory treatment.
Material and Methods:
In this retrospective case-controlled study, 64 children with MIS-C and 95 healthy age and gender matched children were included. Patients were divided into three clinical severity groups; mild, moderate, and severe.
Results:
Mean platelet volume (MPV), MPV to lymphocyte ratio (MPVLR), D-dimer, ferritin, interleukin 6 (IL-6) levels were significantly higher, while albumin levels were lower in the severe MIS-C group compared to all the other groups on admission. Neutrophil-to-lymphocyte ratio (NLR) and derived (d) NLR (d-NLR) levels were significantly higher in the moderate group compared to the mild group. In the pre-treatment period of MIS-C patients had higher MPV, platelet distribution width (PDW) values while they had lower white blood cell, lymphocyte, monocyte, haemoglobin, mean corpuscular volume (MCV), red cell distribution width (RDW), plateletcrit and platelet values compared to the post-treatment group.
Lymphocyte, platelets, and haemoglobin levels were significantly higher in the control group compared to the pre-treatment group. Acute phase reactants, NLR, NMR, PLR, d-NLR, MPVLR and systemic inflammatory index were significantly higher in all MIS-C patients on admission compared to the control group.
Conclusion: Specific routine laboratory test results may be useful in determining disease severity of MIS-C, possibly predict the prognosis and allow early initiation of the appropriate treatment.
Anahtar Kelimeler
disease severity, ; haematological parameters;, inflammatory markers;, Multisystem inflammatory syndrome in children
Kaynakça
- References Referans 1. Borrelli M, Corcione A, Castellano F, et al. Coronavirus Disease 2019 in Children. Front Pediatr 2021; 9:668484. Referans 2. Kabeerdoss J, Pilania RK, Karkhele R, et al (2021) Severe COVID-19, multisystem inflammatory syndrome in children, and Kawasaki disease: immunological mechanisms, clinical manifestations and management. Rheumatol Int 2021; 41:19–32.
- Referans 3. Sancho-Shimizu V, Brodin P, Cobat A, et al. SARS-CoV-2-related MIS-C: A key to the viral and genetic causes of Kawasaki disease? J Exp Med 2021;218(6): e20210446.
- Referans 4. Nakra NA, Blumberg DA, Herrera-Guerra A, Lakshminrusimha S. Multi-System inflammatory syndrome in children (MIS-C) following SARS-CoV-2 Infection: Review of clinical presentation, hypothetical pathogenesis, and proposed management. Children (Basel). 2020;7(7):69.
- Referans 5. Simon Junior H, Sakano TMS, Rodrigues RM, et al. Multisystem inflammatory syndrome associated with COVID-19 from the pediatric emergency physician’s point of view. J Pediatr (Rio J) 2021; 97:140–159.
- Referans 6. Bartsch YC, Wang C, Zohar T, et al. Humoral signatures of protective and pathological SARS-CoV-2 infection in children. Nat Med 2021; 27:454–62.
- Referans 7. Vella LA, Giles JR, Baxter AE, et al. Deep immune profiling of MIS-C demonstrates marked but transient immune activation compared to adult and pediatric COVID-19. Sci Immunol. 2021;6(57): eabf7570.
- Referans 8. Schvartz A, Belot A, Kone-Paut I. Pediatric inflammatory multisystem syndrome and rheumatic diseases during SARS-CoV-2 pandemic. Front Pediatr 2020; 8:605807.
- Referans 9. Ying H-Q, Deng Q-W, He B-S, et al. The prognostic value of preoperative NLR, d-NLR, PLR and LMR for predicting clinical outcome in surgical colorectal cancer patients. Med Oncol 2014;31(12):305.
- Referans 10. Henderson LA, Canna SW, Friedman KG, et al. American College of Rheumatology Clinical Guidance for Multisystem Inflammatory Syndrome in Children Associated with SARS-CoV-2 and Hyperinflammation in Pediatric COVID-19: Version 2. Arthritis Rheumatol 2021;73: e13–e29.
- Referans 11. Jonat B, Gorelik M, Boneparth A, et al. Multisystem inflammatory syndrome in children associated with Coronavirus Disease 2019 in a children’s hospital in New York City: Patient characteristics and an institutional protocol for evaluation, management, and follow-up. Pediatr Crit Care Med 2021;22: e178–91.