Urea/Creatinine Ratio’s Correlation with Creatine Kinase Normalization in Pediatric COVID-19 Patients with Myositis: Evaluating Prognostic and Predictive Value

Coronavirus disease 2019 (COVID-19) has been chiefly linked with substantial respiratory complications. However, emerging studies have brought attention to the occurrence of severe muscle inflammation (myositis) related to COVID-19, potentially leading to multi-organ failure and increased mortality....

Full description

Bibliographic Details
Main Authors: Francesco Pizzo, Andrea Marino, Alessandra Di Nora, Serena Spampinato, Giovanni Cacciaguerra, Giuseppe Costanza, Federica Scarlata, Arturo Biasco, Maria Chiara Consentino, Riccardo Lubrano, Bruno Cacopardo, Giuseppe Nunnari, Martino Ruggieri, Piero Pavone
Format: Article
Language:English
Published: MDPI AG 2023-12-01
Series:Infectious Disease Reports
Subjects:
Online Access:https://www.mdpi.com/2036-7449/16/1/2
_version_ 1797298071101505536
author Francesco Pizzo
Andrea Marino
Alessandra Di Nora
Serena Spampinato
Giovanni Cacciaguerra
Giuseppe Costanza
Federica Scarlata
Arturo Biasco
Maria Chiara Consentino
Riccardo Lubrano
Bruno Cacopardo
Giuseppe Nunnari
Martino Ruggieri
Piero Pavone
author_facet Francesco Pizzo
Andrea Marino
Alessandra Di Nora
Serena Spampinato
Giovanni Cacciaguerra
Giuseppe Costanza
Federica Scarlata
Arturo Biasco
Maria Chiara Consentino
Riccardo Lubrano
Bruno Cacopardo
Giuseppe Nunnari
Martino Ruggieri
Piero Pavone
author_sort Francesco Pizzo
collection DOAJ
description Coronavirus disease 2019 (COVID-19) has been chiefly linked with substantial respiratory complications. However, emerging studies have brought attention to the occurrence of severe muscle inflammation (myositis) related to COVID-19, potentially leading to multi-organ failure and increased mortality. Myositis is generally characterized by heightened serum creatine kinase (CK) levels. Acute myositis is characterized by an infiltration of viruses into calf muscle fibers, which may cause a subsequent inflammatory response leading to calf muscle pain. Symptomatic and supportive management, along with explanation and reassurance, is all that is required in managing this condition. While the association between myositis and severe outcomes has been recognized in adults, it remains less understood in the pediatric population. The current retrospective study, conducted at Policlinico San Marco University Hospital in Catania, aimed to analyze clinical and laboratory factors associated with myositis in pediatric patients with SARS-CoV-2 infection. Between January 2022 and January 2023, ten pediatric patients diagnosed with myositis and SARS-CoV-2 infection were evaluated. The study highlighted clinical manifestations such as fever, calf muscle pain, and abnormal gait. Lab results showed elevated CK levels among other findings. All patients underwent treatment, with the majority recovering without complications. A notable correlation was observed between CK levels, blood urea nitrogen (BUN), and the urea/creatinine ratio (UCR). The study also discusses potential pathophysiological mechanisms behind SARS-CoV-2’s impact on skeletal muscles, emphasizing an indirect inflammatory response. Our findings underscore that while myositis in children with SARS-CoV-2 infection appears to follow a benign and self-limiting trajectory, it is crucial to monitor specific markers for early intervention and management. Further research is warranted to elucidate the underlying mechanisms and improve clinical outcomes.
first_indexed 2024-03-07T22:29:33Z
format Article
id doaj.art-49732276668c4fe9bde033f6ed55f8fa
institution Directory Open Access Journal
issn 2036-7449
language English
last_indexed 2024-03-07T22:29:33Z
publishDate 2023-12-01
publisher MDPI AG
record_format Article
series Infectious Disease Reports
spelling doaj.art-49732276668c4fe9bde033f6ed55f8fa2024-02-23T15:19:02ZengMDPI AGInfectious Disease Reports2036-74492023-12-01161132510.3390/idr16010002Urea/Creatinine Ratio’s Correlation with Creatine Kinase Normalization in Pediatric COVID-19 Patients with Myositis: Evaluating Prognostic and Predictive ValueFrancesco Pizzo0Andrea Marino1Alessandra Di Nora2Serena Spampinato3Giovanni Cacciaguerra4Giuseppe Costanza5Federica Scarlata6Arturo Biasco7Maria Chiara Consentino8Riccardo Lubrano9Bruno Cacopardo10Giuseppe Nunnari11Martino Ruggieri12Piero Pavone13Postgraduate Training Programme in Pediatrics, Department of Clinical and Experimental Medicine, University of Catania, Via S. Sofia 78, 95123 Catania, ItalyInfectious Diseases Unit, Department of Clinical and Experimental Medicine, ARNAS Garibaldi Hospital, University of Catania, 95122 Catania, ItalyPostgraduate Training Programme in Pediatrics, Department of Clinical and Experimental Medicine, University of Catania, Via S. Sofia 78, 95123 Catania, ItalyDepartment of Clinical and Experimental Medicine, University of Messina, 98122 Messina, ItalyPostgraduate Training Programme in Pediatrics, Department of Clinical and Experimental Medicine, University of Catania, Via S. Sofia 78, 95123 Catania, ItalyPostgraduate Training Programme in Pediatrics, Department of Clinical and Experimental Medicine, University of Catania, Via S. Sofia 78, 95123 Catania, ItalyPostgraduate Training Programme in Pediatrics, Department of Clinical and Experimental Medicine, University of Catania, Via S. Sofia 78, 95123 Catania, ItalyPostgraduate Training Programme in Pediatrics, Department of Clinical and Experimental Medicine, University of Catania, Via S. Sofia 78, 95123 Catania, ItalyPostgraduate Training Programme in Pediatrics, Department of Clinical and Experimental Medicine, University of Catania, Via S. Sofia 78, 95123 Catania, ItalyDepartment of Paediatrics, Sapienza University of Rome, Viale del Policlinico 155, 00161 Roma, ItalyInfectious Diseases Unit, Department of Clinical and Experimental Medicine, ARNAS Garibaldi Hospital, University of Catania, 95122 Catania, ItalyInfectious Diseases Unit, Department of Clinical and Experimental Medicine, ARNAS Garibaldi Hospital, University of Catania, 95122 Catania, ItalyDepartment of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University Hospital “Policlinico G. Rodolico”, 95125 Catania, ItalyDepartment of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University Hospital “Policlinico G. Rodolico”, 95125 Catania, ItalyCoronavirus disease 2019 (COVID-19) has been chiefly linked with substantial respiratory complications. However, emerging studies have brought attention to the occurrence of severe muscle inflammation (myositis) related to COVID-19, potentially leading to multi-organ failure and increased mortality. Myositis is generally characterized by heightened serum creatine kinase (CK) levels. Acute myositis is characterized by an infiltration of viruses into calf muscle fibers, which may cause a subsequent inflammatory response leading to calf muscle pain. Symptomatic and supportive management, along with explanation and reassurance, is all that is required in managing this condition. While the association between myositis and severe outcomes has been recognized in adults, it remains less understood in the pediatric population. The current retrospective study, conducted at Policlinico San Marco University Hospital in Catania, aimed to analyze clinical and laboratory factors associated with myositis in pediatric patients with SARS-CoV-2 infection. Between January 2022 and January 2023, ten pediatric patients diagnosed with myositis and SARS-CoV-2 infection were evaluated. The study highlighted clinical manifestations such as fever, calf muscle pain, and abnormal gait. Lab results showed elevated CK levels among other findings. All patients underwent treatment, with the majority recovering without complications. A notable correlation was observed between CK levels, blood urea nitrogen (BUN), and the urea/creatinine ratio (UCR). The study also discusses potential pathophysiological mechanisms behind SARS-CoV-2’s impact on skeletal muscles, emphasizing an indirect inflammatory response. Our findings underscore that while myositis in children with SARS-CoV-2 infection appears to follow a benign and self-limiting trajectory, it is crucial to monitor specific markers for early intervention and management. Further research is warranted to elucidate the underlying mechanisms and improve clinical outcomes.https://www.mdpi.com/2036-7449/16/1/2SARS-CoV-2 infectionpediatric COVID-19COVID-19 myositisCOVID-19 myolysis
spellingShingle Francesco Pizzo
Andrea Marino
Alessandra Di Nora
Serena Spampinato
Giovanni Cacciaguerra
Giuseppe Costanza
Federica Scarlata
Arturo Biasco
Maria Chiara Consentino
Riccardo Lubrano
Bruno Cacopardo
Giuseppe Nunnari
Martino Ruggieri
Piero Pavone
Urea/Creatinine Ratio’s Correlation with Creatine Kinase Normalization in Pediatric COVID-19 Patients with Myositis: Evaluating Prognostic and Predictive Value
Infectious Disease Reports
SARS-CoV-2 infection
pediatric COVID-19
COVID-19 myositis
COVID-19 myolysis
title Urea/Creatinine Ratio’s Correlation with Creatine Kinase Normalization in Pediatric COVID-19 Patients with Myositis: Evaluating Prognostic and Predictive Value
title_full Urea/Creatinine Ratio’s Correlation with Creatine Kinase Normalization in Pediatric COVID-19 Patients with Myositis: Evaluating Prognostic and Predictive Value
title_fullStr Urea/Creatinine Ratio’s Correlation with Creatine Kinase Normalization in Pediatric COVID-19 Patients with Myositis: Evaluating Prognostic and Predictive Value
title_full_unstemmed Urea/Creatinine Ratio’s Correlation with Creatine Kinase Normalization in Pediatric COVID-19 Patients with Myositis: Evaluating Prognostic and Predictive Value
title_short Urea/Creatinine Ratio’s Correlation with Creatine Kinase Normalization in Pediatric COVID-19 Patients with Myositis: Evaluating Prognostic and Predictive Value
title_sort urea creatinine ratio s correlation with creatine kinase normalization in pediatric covid 19 patients with myositis evaluating prognostic and predictive value
topic SARS-CoV-2 infection
pediatric COVID-19
COVID-19 myositis
COVID-19 myolysis
url https://www.mdpi.com/2036-7449/16/1/2
work_keys_str_mv AT francescopizzo ureacreatinineratioscorrelationwithcreatinekinasenormalizationinpediatriccovid19patientswithmyositisevaluatingprognosticandpredictivevalue
AT andreamarino ureacreatinineratioscorrelationwithcreatinekinasenormalizationinpediatriccovid19patientswithmyositisevaluatingprognosticandpredictivevalue
AT alessandradinora ureacreatinineratioscorrelationwithcreatinekinasenormalizationinpediatriccovid19patientswithmyositisevaluatingprognosticandpredictivevalue
AT serenaspampinato ureacreatinineratioscorrelationwithcreatinekinasenormalizationinpediatriccovid19patientswithmyositisevaluatingprognosticandpredictivevalue
AT giovannicacciaguerra ureacreatinineratioscorrelationwithcreatinekinasenormalizationinpediatriccovid19patientswithmyositisevaluatingprognosticandpredictivevalue
AT giuseppecostanza ureacreatinineratioscorrelationwithcreatinekinasenormalizationinpediatriccovid19patientswithmyositisevaluatingprognosticandpredictivevalue
AT federicascarlata ureacreatinineratioscorrelationwithcreatinekinasenormalizationinpediatriccovid19patientswithmyositisevaluatingprognosticandpredictivevalue
AT arturobiasco ureacreatinineratioscorrelationwithcreatinekinasenormalizationinpediatriccovid19patientswithmyositisevaluatingprognosticandpredictivevalue
AT mariachiaraconsentino ureacreatinineratioscorrelationwithcreatinekinasenormalizationinpediatriccovid19patientswithmyositisevaluatingprognosticandpredictivevalue
AT riccardolubrano ureacreatinineratioscorrelationwithcreatinekinasenormalizationinpediatriccovid19patientswithmyositisevaluatingprognosticandpredictivevalue
AT brunocacopardo ureacreatinineratioscorrelationwithcreatinekinasenormalizationinpediatriccovid19patientswithmyositisevaluatingprognosticandpredictivevalue
AT giuseppenunnari ureacreatinineratioscorrelationwithcreatinekinasenormalizationinpediatriccovid19patientswithmyositisevaluatingprognosticandpredictivevalue
AT martinoruggieri ureacreatinineratioscorrelationwithcreatinekinasenormalizationinpediatriccovid19patientswithmyositisevaluatingprognosticandpredictivevalue
AT pieropavone ureacreatinineratioscorrelationwithcreatinekinasenormalizationinpediatriccovid19patientswithmyositisevaluatingprognosticandpredictivevalue