Department of Pediatrics, People's Hospital of Chongqing Banan District, Chongqing 401320, China.
Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, TX, USA.
Am J Emerg Med. 2021 Nov;49:62-70. doi: 10.1016/j.ajem.2021.05.044. Epub 2021 May 18.
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).
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.
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.
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.
对 2019 冠状病毒病（COVID-19）患者中与多系统炎症综合征（MIS-C）相关的实验室心脏标志物进行荟萃分析。
检索 8 个数据库，截至 2021 年 4 月 10 日，以纳入关于心脏标志物（包括 B 型利钠肽（BNP）/氨基末端 pro-BNP（NT-proBNP）、肌钙蛋白、天门冬氨酸氨基转移酶（AST））的 MIS-C 患者的研究。
24 项研究共纳入 2583 名参与者，其中 1613 名患者被诊断为 MIS-C。与非重症 COVID-19 患者相比，MIS-C 患者的 BNP 水平更高[SMD（95%CI）：1.13（0.48，1.77），p < 0.05]。与重症 COVID-19 患者相比，MIS-C 患者的 BNP 水平无显著差异[SMD（95%CI）：0.29（-0.07，0.65），p = 0.117]。与所有 COVID-19 患者相比，MIS-C 患者的肌钙蛋白水平无显著差异[SMD（95%CI）：0.13（-0.07，0.32），p = 0.212]或 AST 水平[SMD（95%CI）：0.10（-0.11，0.31），p = 0.336]。与非重症 MIS-C 患者相比，重症 MIS-C 患者的 BNP 水平更高[SMD（95%CI）：0.26（0.04，0.48），p < 0.05]，但肌钙蛋白[SMD（95%CI）：0.05（-0.06，0.16），p = 0.387]或 AST[SMD（95%CI）：0.19（-0.34，0.71），p = 0.483]水平无显著差异。此外，在有或无冠状动脉异常的 MIS-C 患者中，BNP[SMD（95%CI）：-0.21（-1.07，0.64），p = 0.624]或肌钙蛋白[SMD（95%CI）：-0.07（-0.45，0.31），p = 0.710]水平均无显著差异。进行敏感性分析以评估稳定性。基于贝叶斯检验，未发现发表偏倚。
在 MIS-C/非重症 COVID-19 患者和重症/非重症 MIS-C 患者之间存在差异的关键心脏标志物是 BNP。其他标志物，如肌钙蛋白和 AST，在指示 MIS-C 和 COVID-19 患者的心肌损伤方面没有明显差异。
