Year :
2023
| Month :
January
| Volume :
17
| Issue :
1
| Page :
SC01 - SC06
Role of Inflammatory Markers and Clinical Correlate in Children Infected with the Novel SARS-CoV-2: A Prospective Observational Study
Amitabh Singh, Shruti Jain, Vikramjeet Dutta, Sumita Saluja, Rajni Gaind, Shobha Sharma
1. Associate Professor, Department of Paediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, Delhi, India.
2. Senior Resident, Department of Paediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, Delhi, India.
3. Associate Professor, Department of Microbiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, Delhi, India.
4. Professor, Department of Haematology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, Delhi, India.
5. Professor, Department of Microbiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, Delhi, India.
6. Professor, Department of Paediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, Delhi, India.
Correspondence Address :
Dr. Shobha Sharma,
C-31, Nivedita Kunj, Sector 10, R K Puram, New Delhi, India.
E-mail: oum.shobha76@gmail.com
Abstract
Introduction: Inflammatory markers have been used as predictors of adverse outcomes in adults with Coronavirus Disease-2019 (COVID-19) infection. Children mostly have mild infections and raised inflammatory markers have been reported only with severe COVID-19 or Multisystem Inflammatory Disorder (MIS-C). Studies in children showing the role of inflammatory markers in disease prognosis are few, and findings are not conclusive.
Aim: To find out correlation, if any, between the inflammatory markers {Interleukin-6 (IL-6), C-reactive Protein (CRP), procalcitonin, Pro-B-type natriuretic Peptide (Pro-BNP), ferritin, D-dimer} with clinical presentation, prognosis, and outcome in children with acute COVID-19.
Materials and Methods: The hospital-based, prospective observational study was conducted at a tertiary care COVID-19 Paediatric Intensive Care Unit {PICU (Vardhaman Medical College and Hospital, New Delhi)}, Northern India, between September 2020 and December 2020. All children aged less than 12 years, with a positive COVID-19 report were enrolled and investigated. Data was collected for clinical presentation, severity, treatment and outcome. The following variables were recorded: Complete Blood Count (CBC), Kidney Function Test (KFT) and Liver function Test (LFT), Absolute Lymphocyte Count (ALC), Absolute Neutrophil Count (ANC), Neutrophil-lymphocyte Ratio (NLR), Platelet Count (PLT), C-reactive Protein (CRP), Procalcitonin (PCT), serum ferritin, Lactate Dehydrogenase (LDH), fibrinogen, and Erythrocyte Sedimentation Rate (ESR) and ProBNP. Coagulation parameters like Prothrombin Time (PT), Activated Partial Thromboplastin Time (APTT), International Normalised Ration (INR), D-dimer were taken. Data was analysed using Statistical Package for the Social Sciences (SPSS) software version 21.0.
Results: A total of 35 children were admitted during the study period. Seventeen children met the criteria for severe disease. Seven children met the criteria for MIS-C. Children presenting with conjunctivitis (n=3) were more likely to have signs of peripheral inflammation hypotension (n=4), tachycardia (n=6), and raised IL-6 levels (pg/mL) as well as the need for inotropic support. IL-6 values were higher in children (Mean±SD=182.47±149.83). Median IL-6 value 199.8 (96.17-275.24) was highest in children with CRP <10 mg/dL (p-value <0.01). Children with raised D-dimer (Mean±SD=1881.94±1265.66 mg/dL) had a longer duration of stay (p-value=0.031).
Conclusion: The study didn’t find any correlation between inflammatory markers with clinical presentation and the outcome of COVID-19 infection in children.
Keywords
Coronavirus disease-2019, D-dimer, Interleukin-6, Remdesivir, Severe acute respiratory distress syndrome coronavirus 2
DOI and Others
DOI: 10.7860/JCDR/2023/58491.17247
Date of Submission: Jun 16, 2022
Date of Peer Review: Jul 22, 2022
Date of Acceptance: Oct 01, 2022
Date of Publishing: Jan 01, 2023
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA
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ETYMOLOGY: Author Origin
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