Cardiac markers of multisystem inflammatory syndrome in children (MIS-C) in COVID-19 patients: A meta-analysis - 29/10/21
, Jenil Patel b, Ying Huang c, Lijuan Yin c, ⁎ , Lei Tang a, ⁎⁎
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Abstract |
Objective |
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).
Methods |
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.
Results |
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.
Conclusions |
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.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Severe MIS-C patients showed higher BNP than non-severe MIS-C patients, but no differences in troponin or AST were observed. |
• | MIS-C patients exhibited higher BNP levels than non-severe COVID-19 patients, but noted equal to severe COVID-19 patients. |
• | No significant differences were noted in troponin and AST levels between MIS-C patients and COVID-19 patients. |
• | BNP and troponin levels were not significantly different between MIS-C patients with and without CAA. |
Keywords : COVID-19, PMIS/PIMS-TS/MIS-C, BNP, Troponin, Children, Meta-analysis
Abbreviations : ACE2, AST, BNP, COVID-19, CAA, FEM, ICU, MIS-C, NT-proBNP, REM, SMD, SARS-CoV-2, 95%CI
Plan
Vol 49
P. 62-70 - novembre 2021 Retour au numéro
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