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Can we predict risk for cardiac involvement in paediatric inflammatory multi-system syndrome?

Published online by Cambridge University Press:  24 January 2022

Nurhayat Yakut Open the ORCID record for Nurhayat Yakut [Opens in a new window] ,
Ibrahim Cansaran Tanidir Open the ORCID record for Ibrahim Cansaran Tanidir [Opens in a new window] ,
Kahraman Yakut Open the ORCID record for Kahraman Yakut [Opens in a new window] ,
Sezgin Sahin Open the ORCID record for Sezgin Sahin [Opens in a new window] ,
Arda Kilinc ,
Irem Kabasakal ,
Merih Cetinkaya ,
Hasan Onal  and
Erkut Ozturk
Nurhayat Yakut*
Affiliation:
Department of Pediatrics, Division of Pediatric Infectious Diseases, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
Ibrahim Cansaran Tanidir
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
Kahraman Yakut
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
Sezgin Sahin
Affiliation:
Department of Pediatrics, Division of Pediatric Rheumatology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
Arda Kilinc
Affiliation:
Department of Pediatrics, Division of Pediatric Intensive Care, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
Irem Kabasakal
Affiliation:
Department of Pediatrics, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
Merih Cetinkaya
Affiliation:
Department of Pediatrics, Division of Neonatology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
Hasan Onal
Affiliation:
Department of Pediatrics, Division of Pediatric Endocrinology and Metabolism, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
Erkut Ozturk
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
*
Author for correspondence: Nurhayat Yakut, MD, Department of Pediatrics, Division of Pediatric Infectious Diseases, Basaksehir Cam and Sakura City Hospital, Başakşehir Olimpiyat Street, 34480 Başakşehir, Istanbul, Turkey. Tel: 05057323568. E-mail: nurhayatyakut@gmail.com
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Abstract

Introduction:

Increasing recognition of paediatric inflammatory multi-system syndrome is a cause of concern. This study aimed to evaluate children with paediatric inflammatory multi-system syndrome and compare the clinical and laboratory features of children with and without cardiac involvement.

Material and methods:

We conducted a prospective single-centre study including 57 (male 37, 65%) patients with paediatric inflammatory multi-system syndrome at a tertiary care hospital between November, 2020 and March, 2021. The mean age was 8.8 ± 4.5 years (range, 10 months–16.7 years).

Results:

The most frequent symptoms were fever (100%), abdominal pain (65%) and diarrhoea (42%). SARS-CoV-2 PCR and serology tests were positive in 3 (5%) and 52 (91%) patients, respectively. Eight patients required intensive care support. Nineteen patients (33%) had cardiac involvement (valvular regurgitation in 15, left ventricular systolic dysfunction in 11 and coronary artery dilation in 1). The presence and duration of cough and intensive care admissions were significantly higher in children with cardiac involvement than those without it. The cut-off values of troponin T, pro-brain natriuretic peptide and interleukin 6 for predicting cardiac involvement were 11.65 ng/L (95% confidence interval, 0.63–0.90; sensitivity, 0.63; specificity, 0.84; area under the curve: 0.775, p = 0.009), 849.5 pg/mL (95% CI, 0.54–0.86; sensitivity, 0.63; specificity, 0.63; area under the curve: 0.706, p = 0.009) and 39.8 pg/mL (95% CI, 0.54–0.85; sensitivity, 0.63; specificity, 0.60; area under the curve: 0.698, p = 0.023), respectively.

Conclusions:

Cardiac involvement in children with paediatric inflammatory multi-system syndrome is common. The risk of cardiac involvement can be predicted by troponin T, pro-brain natriuretic peptide and interleukin 6 levels.

Keywords

Paediatric inflammatory multi-system syndromechildrenriskcardiac involvementechocardiography
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 12 , December 2022 , pp. 1944 - 1951
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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