Department of Pediatric Cardiology and Rheumatology, Medical University of Lodz, Sporna 36/50 street, 91-738, Lodz, Poland.
Department of Biostatistics and Translational Medicine, Medical University of Lodz, Lodz, Poland.
Eur J Pediatr. 2022 Oct;181(10):3733-3738. doi: 10.1007/s00431-022-04584-8. Epub 2022 Aug 10.
Pediatric multi-system inflammatory syndrome temporally associated with COVID-19 (PIMS-TS) is a serious complication of a previous SARS-CoV-2 infection. The disease causes multiple organ failure, but in some patients, a more severe course of the disease is observed. The treatment is multidirectional and depends on the severity and course of the disease, as some patients do not respond to the recommended treatment. The aim of this study was to identify laboratory risk factors affecting the more severe course of the disease and resistance to standard therapy. It is a single-center retrospective study considering 51 patients with PIMS-TS. Clinical features, laboratory results, and additional imaging tests data were taken into account. Fifty-one patients with PIMS-TS were hospitalized within a 16-month observation period. In the studied group, 26/51 children (51%) were girls. The mean age of patients was 7 years. Sex of the patient was not a risk factor for changes in cardiovascular system or severe course of the disease. Sixteen patients (31.3%) required transfer to the intensive care unit. Children with initially higher concentrations of NT-proBNP, troponin, creatinine, triglycerides, C-reactive protein, procalcitonin, ferritin, D-dimers and lower hematocrit, platelet count, lymphocytes, and ejection fraction should be strictly observed as they have a higher risk of severe course of the disease.
Laboratory parameters especially markers of myocardial damage, markers of inflammation, blood count, as wells as biochemical parameters are significant risk indicators of severe course of PIMS -TS and their concentration can be defined as predictor of disease severity.
• Pediatric multisystem inflammatory syndrome temporally associated with COVID-19 (PIMS-TS) is a serious complication of a previous SARS-CoV-2 infection in the group of pediatric patients • Course of the disease may be severe, which may cause long-term complications and the need for longitudinal patient care.
• Children with higher concentrations of NT-proBNP, troponin, creatinine, TG, CRP, PCT, ferritin, D-dimers and lower hematocrit, PLT, lymphocytes, and EF have a higher risk of a severe course of the disease. • Patients with high concentration of NT-proBNP, troponin, CRP, lactates, ferritin, D-dimers, creatinine and a lower concentration of PLT, albumin, leukocytes; lymphopenia, hyponatremia are at risk for intravenous immunoglobulin resistance.
本研究旨在确定影响疾病更严重程度和对标准治疗产生抵抗的实验室风险因素。
这是一项为期 16 个月的单中心回顾性研究，共纳入 51 例 PIMS-TS 患者。考虑了患者的临床特征、实验室结果和其他影像学检查数据。
在研究组中，51 例患儿中有 26 例（51%）为女孩。患者的平均年龄为 7 岁。患儿性别并不是心血管系统改变或疾病严重程度的危险因素。16 例（31.3%）患者需要转入重症监护病房。最初 NT-proBNP、肌钙蛋白、肌酐、甘油三酯、C 反应蛋白、降钙素原、铁蛋白、D-二聚体浓度较高，而血细胞比容、血小板计数、淋巴细胞和射血分数较低的患儿应密切观察，因为他们发生严重疾病的风险较高。
实验室参数，特别是心肌损伤标志物、炎症标志物、血细胞计数以及生化参数，是 PIMS-TS 严重程度的重要危险因素，其浓度可作为疾病严重程度的预测指标。
