Department of Pediatric Infectious Diseases, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, Istanbul 34098, Turkey.
Department of Pediatric Pulmonology, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, Istanbul 34098, Turkey.
J Trop Pediatr. 2022 Feb 3;68(2). doi: 10.1093/tropej/fmac003.
Predictors of early diagnosis and severe infection in children with coronavirus disease 2019 (COVID-19), which has killed more than 4 million people worldwide, have not been identified. However, some biomarkers, including cytokines and chemokines, are associated with the diagnosis, pathogenesis and severity of COVID-19 in adults. We examined whether such biomarkers can be used to predict the diagnosis and prognosis of COVID-19 in pediatric patients. Eighty-nine children were included in the study, comprising three patient groups of 69 patients (6 severe, 36 moderate and 27 mild) diagnosed with COVID-19 by real-time polymerase chain reaction observed for 2-216 months and clinical findings and 20 healthy children in the same age group. Hemogram, coagulation, inflammatory parameters and serum levels of 16 cytokines and chemokines were measured in blood samples and were analyzed and compared with clinical data. Interleukin 1-beta (IL-1β), interleukin-12 (IL-12) and interferon gamma-induced protein 10 (IP-10) levels were significantly higher in the COVID-19 patients (p = 0.035, p = 0.006 and p < 0.001). Additionally, D-dimer and IP-10 levels were higher in the severe group (p = 0.043 for D-dimer, area under the curve = 0.743, p = 0.027 for IP-10). Lymphocytes, C-reactive protein and procalcitonin levels were not diagnostic or prognostic factors in pediatric patients (p = 0.304, p = 0.144 and p = 0.67). Increased IL-1β, IL-12 and IP-10 levels in children with COVID-19 are indicators for early diagnosis, and D-dimer and IP-10 levels are predictive of disease severity. In children with COVID-19, these biomarkers can provide information on prognosis and enable early treatment.
新型冠状病毒病 2019（COVID-19）已导致全球超过 400 万人死亡，但尚未确定其早期诊断和严重感染的预测因素。然而，一些生物标志物，包括细胞因子和趋化因子，与成人 COVID-19 的诊断、发病机制和严重程度相关。我们研究了这些生物标志物是否可用于预测儿科患者 COVID-19 的诊断和预后。本研究纳入 89 例患儿，包括三组 69 例（6 例重症、36 例中度和 27 例轻度）通过实时聚合酶链反应诊断为 COVID-19 的患儿，观察 2-216 个月和临床发现，以及 20 例年龄匹配的健康儿童。采集血样，检测全血细胞计数、凝血、炎症参数和 16 种细胞因子和趋化因子的血清水平，并与临床数据进行分析和比较。COVID-19 患儿的白细胞介素 1-β（IL-1β）、白细胞介素 12（IL-12）和干扰素γ诱导蛋白 10（IP-10）水平显著升高（p = 0.035，p = 0.006 和 p < 0.001）。此外，重症组 D-二聚体和 IP-10 水平较高（p = 0.043，D-二聚体的曲线下面积为 0.743，p = 0.027，IP-10）。淋巴细胞、C 反应蛋白和降钙素原水平不是儿科患者的诊断或预后因素（p = 0.304，p = 0.144 和 p = 0.67）。COVID-19 患儿中 IL-1β、IL-12 和 IP-10 水平升高是早期诊断的指标，D-二聚体和 IP-10 水平可预测疾病严重程度。在 COVID-19 患儿中，这些生物标志物可提供预后信息，并能进行早期治疗。
