Abstract
Background and aim: Occasionally, children with COVID-19 may develop arrhythmia, myocarditis, and cardiogenic shock involving multisystemic inflammatory syndrome in children (MIS-C). This study aimed to identify the laboratory parameters that may predict early cardiovascular involvement in these patients.
Materials and methods: Data of 320 pediatric patients, aged 0-18 years (average age, 10.46 ± 5.77 years; 156 female), with positive COVID-19 reverse transcription-polymerase chain reaction test and with cardiac biomarkers at the time of admission to the pediatric emergency department were retrospectively scanned. The age, sex, COVID-19-associated symptoms, pro-brain natriuretic peptide (proBNP), CK-MB, and troponin I levels of the patients were recorded.
Results: Fever was noted in 58.1% of the patients, cough in 29.7%, diarrhea in 7.8%, headache in 14.7%, sore throat in 17.8%, weakness in 17.8%, abdominal pain in 5%, loss of taste in 4.1%, loss of smell in 5.3%, nausea in 3.4%, vomiting in 3.8%, nasal discharge in 4.4%, muscle pain in 5%, and loss of appetite in 3.1%. The proBNP value ≥282 ng/L predicted the development of MIS-C with 100% sensitivity and 93% specificity [AUC: 0.985 (0.959-1), P < 0.001]; CK-MB value ≥2.95 with 80% sensitivity and 77.6% specificity [AUC: 0.792 (0.581-1), P = 0.026]; and troponin I value ≥0.03 with 60% sensitivity and 99.2% specificity [AUC: 0.794 (0.524-1)].
Conclusions: Cardiac markers (proBNP and troponin I), especially proBNP, could be used to detect early diagnosis of cardiac involvement and/or MIS-C in pediatric patients with COVID-19 and to predict related morbidity and mortality.
Keywords: COVID-19; Cardiac; Children; SARS-CoV-2; Troponin I; proBNP.
【저자키워드】 COVID-19, SARS-CoV-2, children, troponin I, cardiac, proBNP., 【초록키워드】 Biomarker, pediatric, peptide, Sex, troponin, nasal, cough, headache, abdominal pain, diarrhea, Symptoms, discharge, MIS-C, arrhythmia, early diagnosis, sensitivity, specificity, Shock, myocarditis, Pediatric patients, female, Pain, age, morbidity and mortality, Admission, patients, predict, marker, Inflammatory, sore throat, Loss of Smell, Pediatric patient, CK-MB, average, syndrome, loss of taste, nausea, weakness, multisystemic, material, vomiting, loss of appetite, positive COVID-19, laboratory parameter, predicted, identify, detect, develop, the patient, were recorded, children with COVID-19, with COVID-19, 【제목키워드】 Prognosis, Predictive value, cardiac marker,