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Haematological parameters predicting cardiac involvement in children with COVID-19 infection
Ufuk U Güllü1, Sevcan İpek2, Şükrü Güngör3
1Department of Pediatric Cardiology, Kahramanmaraş Sütçü İmam University Medical Faculty, Kahramanmaraş, Turkey.
Insights
Certain blood tests, including neutrophil-to-lymphocyte ratio (NLR), proBNP, and troponin-I, can effectively predict pediatric COVID-19 cardiac complications like MIS-C. These cost-effective markers aid in early risk assessment for better patient outcomes.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Hematology
Background:
- Neutrophil-to-lymphocyte ratio (NLR) and cardiac biomarkers are cost-effective indicators for various disease prognoses.
- Predicting cardiac involvement in COVID-19 infections is crucial for managing pediatric patients.
Purpose of the Study:
- To evaluate haematological parameters and cardiac biomarkers for predicting cardiac involvement in pediatric COVID-19.
- To assess the predictive value of NLR, proBNP, CKMB, and troponin-I for MIS-C in children.
Main Methods:
- Retrospective study of pediatric patients (1 month to 18 years) with positive COVID-19 PCR and no comorbidities.
- Analysis included 292 COVID-19 patients, 12 MIS-C patients, and 70 healthy controls.
- Receiver operator characteristic (ROC) curve and logistic regression analyses were performed.
Main Results:
- NLR (≥5.03), proBNP (≥329.5 ng/L), CKMB (≥2.95 μg/L), and troponin-I (≥0.03 μg/L) showed predictive capabilities for MIS-C.
- High sensitivity and specificity were observed for NLR, proBNP, and troponin-I in predicting MIS-C.
- Logistic regression indicated significant risk increases for MIS-C with elevated NLR (19.3x), proBNP (238x), and troponin-I (60x).
Conclusions:
- ProBNP, troponin-I, and NLR are valuable predictors of MIS-C development in pediatric COVID-19 patients upon admission.
- These haematological and cardiac markers offer high sensitivity and specificity for early detection.
- Early identification using these parameters can guide timely intervention and management strategies.
Aim:
Haematological parameters obtained from the full blood count, such as neutrophil-to-lymphocyte ratio (NLR), are cost-effective tests which have been shown to be predictive of the prognosis of many diseases. We aimed to evaluate certain haematological parameters and cardiac biomarkers to test whether they could predict cardiac involvement by COVID-19 infection.
Methods:
This retrospective study included patients aged 1 month to 18 years having a positive COVID-19 PCR test but no comorbidity, who were admitted to the paediatric emergency department between 15 March 2020 and 1 February 2021.
Results:
There were 292 COVID-19 PCR-positive patients, 12 MIS-C patients and 70 healthy controls. A receiver operator characteristic curve analysis was performed to predict MIS-C in patients with COVID-19 infection. An NLR value of ≥5.03 could predict MIS-C with a sensitivity of 66.7% and a specificity of 91.6%; a proBNP value of ≥329.5 ng/L with a sensitivity of 91.7% and a specificity of 95.6%; a CKMB value of ≥2.95 μg/L with a sensitivity of 100% and a specificity of 77.7%; and a troponin-I value of ≥0.03 μg/L with a sensitivity of 75% and a specificity of 99.2%. A logistic regression analysis showed that an NLR value of ≥5.03 increased the risk of MIS-C 19.3 fold; a proBNP value of ≥329.5 ng/L increased the risk 238 fold; and a troponin-I value of ≥0.03 μg/L increased the risk 60 fold.
Conclusions:
At the time of admission, parameters such as proBNP, troponin-I and NLR can predict the development of MIS-C in COVID-19 patients with high sensitivity and specificity.
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