AI Summary & Key Takeaways
AI InsightConclusion: Specific routine laboratory test results may be useful in determining disease severity of MIS-C, possibly predict the prognosis and allow early initiation of the appropriate treatment.
📌 3 Key Takeaways
Abstract
Abstract Objective: Multisystem inflammatory syndrome in children (MIS-C), is a newly recognised life-threatening complication of coronavirus disease 2019 (COVID-19). Early determination of clinical severity of the disease is important for early decision of treatment regimens. The aim of this study is to investigate the severity classification value of a number of hematological parameters, inflammatory markers and biochemical tests in patients with MIS-C during the acute stage and after anti-inflammatory treatment. Material and Methods: In this retrospective case-controlled study, 64 children with MIS-C and 95 healthy age and gender matched children were included. Patients were divided into three clinical severity groups; mild, moderate, and severe. Results: Mean platelet volume (MPV), MPV to lymphocyte ratio (MPVLR), D-dimer, ferritin, interleukin 6 (IL-6) levels were significantly higher, while albumin levels were lower in the severe MIS-C group compared to all the other groups on admission. Neutrophil-to-lymphocyte ratio (NLR) and derived (d) NLR (d-NLR) levels were significantly higher in the moderate group compared to the mild group. In the pre-treatment period of MIS-C patients had higher MPV, platelet distribution width (PDW) values while they had lower white blood cell, lymphocyte, monocyte, haemoglobin, mean corpuscular volume (MCV), red cell distribution width (RDW), plateletcrit and platelet values compared to the post-treatment group. Lymphocyte, platelets, and haemoglobin levels were significantly higher in the control group compared to the pre-treatment group. Acute phase reactants, NLR, NMR, PLR, d-NLR, MPVLR and systemic inflammatory index were significantly higher in all MIS-C patients on admission compared to the control group. Conclusion: Specific routine laboratory test results may be useful in determining disease severity of MIS-C, possibly predict the prognosis and allow early initiation of the appropriate treatment.
Özet
Abstract Objective: Multisystem inflammatory syndrome in children (MIS-C), is a newly recognised life-threatening complication of coronavirus disease 2019 (COVID-19). Early determination of clinical severity of the disease is important for early decision of treatment regimens. The aim of this study is to investigate the severity classification value of a number of hematological parameters, inflammatory markers and biochemical tests in patients with MIS-C during the acute stage and after anti-inflammatory treatment. Material and Methods: In this retrospective case-controlled study, 64 children with MIS-C and 95 healthy age and gender matched children were included. Patients were divided into three clinical severity groups; mild, moderate, and severe. Results: Mean platelet volume (MPV), MPV to lymphocyte ratio (MPVLR), D-dimer, ferritin, interleukin 6 (IL-6) levels were significantly higher, while albumin levels were lower in the severe MIS-C group compared to all the other groups on admission. Neutrophil-to-lymphocyte ratio (NLR) and derived (d) NLR (d-NLR) levels were significantly higher in the moderate group compared to the mild group. In the pre-treatment period of MIS-C patients had higher MPV, platelet distribution width (PDW) values while they had lower white blood cell, lymphocyte, monocyte, haemoglobin, mean corpuscular volume (MCV), red cell distribution width (RDW), plateletcrit and platelet values compared to the post-treatment group. Lymphocyte, platelets, and haemoglobin levels were significantly higher in the control group compared to the pre-treatment group. Acute phase reactants, NLR, NMR, PLR, d-NLR, MPVLR and systemic inflammatory index were significantly higher in all MIS-C patients on admission compared to the control group. Conclusion: Specific routine laboratory test results may be useful in determining disease severity of MIS-C, possibly predict the prognosis and allow early initiation of the appropriate treatment. Keywords: disease severity; haematological parameters; inflammatory markers; Multisystem inflammatory syndrome in children ÖZ Amaç: Çocuklarda multisistem inflamatuar sendrom (MIS-C), coronavirus disease 2019 (COVID-19)’un yeni tanımlanan yaşamı tehdit eden bir komplikasyonudur. Hastalığın klinik şiddetinin erken tespiti, tedavi rejimlerine erken karar verilmesinde önemlidir. Bu çalışmanın amacı, MIS-C'li hastalarda hematolojik parametrelerin, inflamatuar belirteçlerin ve biyokimyasal testlerin hastalığın cidiyetine göre, akut dönemde ve antiinflamatuar tedavi sonrasındaki değerlerini araştırmaktır. Gereç ve Yöntem: Retrospektif vaka kontrollü çalışmaya MIS-C tanısı alan 64 çocuk ve yaş ve cinsiyet uyumlu 95 sağlıklı çocuk dahil edildi. Hastalar klinik bulgulara göre; hafif, orta ve şiddetli olarak üç gruba ayrıldı. Bulgular: Ciddi MIS-C kliniğinde olan hastalarda hastaneye başvuruda ortalama trombosit hacmi (MPV), MPV/lenfosit oranı (MPVLR), D-dimer, ferritin, interlökin 6 (IL-6) seviyeleri anlamlı olarak daha yüksekken, albumin düzeyleri daha düşüktü. Klinik şiddeti orta olan hastalarda hafif olan hastalara göre; Nötrofil-lenfosit oranı (NLR) ve derived NLR (d-NLR) seviyeleri anlamlı olarak daha yüksek saptandı. MIS-C hastalarında tedavi öncesinde tedavi sonrasına göre MPV, trombosit dağılım genişliği (PDW) değerleri daha yüksekken; beyaz küre sayısı, lenfosit, monosit, hemoglobin, ortalama korpüsküler hacim (MCV), kırmızı hücre dağılım genişliği (RDW), plateletcrit ve trombosit değerleri daha düşüktü. Kontrol grubunda, tedavi öncesi gruba göre lenfosit, trombosit ve hemoglobin düzeyleri anlamlı derecede yüksekti.Akut faz reaktanları, NLR, nötrofil monosit oranı, plateler lenfosit oranı, d-NLR, MPVLR ve sistemik inflamatuar indeks, kontrol grubuna kıyasla tüm MIS-C hastalarında başvuru sırasında anlamlı derecede yüksekti. Sonuç: Spesifik rutin laboratuvar test sonuçları, MIS-C'nin hastalık şiddetini belirlemede, prognozu öngörmede, ve uygun tedavinin erken başlatılmasında yararlı olabilir. Anahtar kelimeler: hastalık şiddeti; hematolojik parametreler; inflamatuar belirteçler; çocuklarda multisistem inflamatuar sendrom