Evaluation of Baseline Characteristics and Prognostic Factors in Multisystemic Inflammatory Syndrome in Children: Is It Possible to Foresee the Prognosis in the First Step?
Background: Two years after the first cases, critical gaps remain in identifying prognostic factors in multisystem inflammatory syndrome in children (MIS-C). Methods: This retrospective study included 99 patients with MIS-C hospitalized between August 2020 and March 2022 in a pediatric tertiary cent...
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MDPI AG
2022-08-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/15/4615 |
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| author | Benhur Sirvan Cetin Ayşenur Paç Kısaarslan Sedanur Tekin Merve Basol Goksuluk Ali Baykan Başak Nur Akyıldız Yılmaz Seçilmiş Hakan Poyrazoglu on behalf of the Erciyes MIS-C Study Group |
| author_facet | Benhur Sirvan Cetin Ayşenur Paç Kısaarslan Sedanur Tekin Merve Basol Goksuluk Ali Baykan Başak Nur Akyıldız Yılmaz Seçilmiş Hakan Poyrazoglu on behalf of the Erciyes MIS-C Study Group |
| author_sort | Benhur Sirvan Cetin |
| collection | DOAJ |
| description | Background: Two years after the first cases, critical gaps remain in identifying prognostic factors in multisystem inflammatory syndrome in children (MIS-C). Methods: This retrospective study included 99 patients with MIS-C hospitalized between August 2020 and March 2022 in a pediatric tertiary center. The patients were divided into two groups according to clinical severity (low- and high-risk). Prognostic values of baseline clinical and laboratory characteristics were evaluated with advanced statistical analysis, including machine learning. Results: Sixty-three patients were male, and the median age was 83 (3–205) months. Fifty-nine patients (59.6%) were low-risk cases. Patients aged six years and over tended to be at higher risk. Involvement of aortic or tricuspid valve or >1 valve was more frequent in the high-risk group. Mortality in previously healthy children was 3.2%. Intensive care unit admission and mortality rate in the high-risk group were 37.5% and 7.5%, respectively. At admission, high-risk patients were more likely to have reduced lymphocyte count and total protein level and increased brain natriuretic peptide (BNP), ferritin, D-dimer, and troponin concentrations. The multiple logistic regression model showed that BNP, total protein, and troponin were associated with higher risk. When the laboratory parameters were used together, BNP, total protein, ferritin, and D-dimer provided the highest contribution to the discrimination of the risk groups (100%, 89.6%, 85.6%, and 55.8%, respectively). Conclusions: Our study widely evaluates and points to some clinical and laboratory parameters that, at admission, may indicate a more severe course. Modeling studies with larger sample groups are strongly needed. |
| first_indexed | 2024-03-09T05:17:06Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T05:17:06Z |
| publishDate | 2022-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-50ae832777f14e7a9c53bb68b509c6052023-12-03T12:44:14ZengMDPI AGJournal of Clinical Medicine2077-03832022-08-011115461510.3390/jcm11154615Evaluation of Baseline Characteristics and Prognostic Factors in Multisystemic Inflammatory Syndrome in Children: Is It Possible to Foresee the Prognosis in the First Step?Benhur Sirvan Cetin0Ayşenur Paç Kısaarslan1Sedanur Tekin2Merve Basol Goksuluk3Ali Baykan4Başak Nur Akyıldız5Yılmaz Seçilmiş6Hakan Poyrazoglu7on behalf of the Erciyes MIS-C Study GroupDivision of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Erciyes University, 38039 Kayseri, TurkeyDivision of Pediatric Rheumatology, Department of Pediatrics, Faculty of Medicine, Erciyes University, 38039 Kayseri, TurkeyDepartment of Pediatrics, Faculty of Medicine, Erciyes University, 38039 Kayseri, TurkeyDepartment of Biostatistics, Faculty of Medicine, Erciyes University, 38039 Kayseri, TurkeyDivision of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Erciyes University, 38039 Kayseri, TurkeyDivision of Pediatric Intensive Care Unit, Department of Pediatrics, Faculty of Medicine, Erciyes University, 38039 Kayseri, TurkeyDivision of Pediatric Emergency, Department of Pediatrics, Faculty of Medicine, Erciyes University, 38039 Kayseri, TurkeyDivision of Pediatric Rheumatology, Department of Pediatrics, Faculty of Medicine, Erciyes University, 38039 Kayseri, TurkeyBackground: Two years after the first cases, critical gaps remain in identifying prognostic factors in multisystem inflammatory syndrome in children (MIS-C). Methods: This retrospective study included 99 patients with MIS-C hospitalized between August 2020 and March 2022 in a pediatric tertiary center. The patients were divided into two groups according to clinical severity (low- and high-risk). Prognostic values of baseline clinical and laboratory characteristics were evaluated with advanced statistical analysis, including machine learning. Results: Sixty-three patients were male, and the median age was 83 (3–205) months. Fifty-nine patients (59.6%) were low-risk cases. Patients aged six years and over tended to be at higher risk. Involvement of aortic or tricuspid valve or >1 valve was more frequent in the high-risk group. Mortality in previously healthy children was 3.2%. Intensive care unit admission and mortality rate in the high-risk group were 37.5% and 7.5%, respectively. At admission, high-risk patients were more likely to have reduced lymphocyte count and total protein level and increased brain natriuretic peptide (BNP), ferritin, D-dimer, and troponin concentrations. The multiple logistic regression model showed that BNP, total protein, and troponin were associated with higher risk. When the laboratory parameters were used together, BNP, total protein, ferritin, and D-dimer provided the highest contribution to the discrimination of the risk groups (100%, 89.6%, 85.6%, and 55.8%, respectively). Conclusions: Our study widely evaluates and points to some clinical and laboratory parameters that, at admission, may indicate a more severe course. Modeling studies with larger sample groups are strongly needed.https://www.mdpi.com/2077-0383/11/15/4615COVID-19multisystem inflammatory syndrome in children (MIS-C)risk classificationprognosis |
| spellingShingle | Benhur Sirvan Cetin Ayşenur Paç Kısaarslan Sedanur Tekin Merve Basol Goksuluk Ali Baykan Başak Nur Akyıldız Yılmaz Seçilmiş Hakan Poyrazoglu on behalf of the Erciyes MIS-C Study Group Evaluation of Baseline Characteristics and Prognostic Factors in Multisystemic Inflammatory Syndrome in Children: Is It Possible to Foresee the Prognosis in the First Step? Journal of Clinical Medicine COVID-19 multisystem inflammatory syndrome in children (MIS-C) risk classification prognosis |
| title | Evaluation of Baseline Characteristics and Prognostic Factors in Multisystemic Inflammatory Syndrome in Children: Is It Possible to Foresee the Prognosis in the First Step? |
| title_full | Evaluation of Baseline Characteristics and Prognostic Factors in Multisystemic Inflammatory Syndrome in Children: Is It Possible to Foresee the Prognosis in the First Step? |
| title_fullStr | Evaluation of Baseline Characteristics and Prognostic Factors in Multisystemic Inflammatory Syndrome in Children: Is It Possible to Foresee the Prognosis in the First Step? |
| title_full_unstemmed | Evaluation of Baseline Characteristics and Prognostic Factors in Multisystemic Inflammatory Syndrome in Children: Is It Possible to Foresee the Prognosis in the First Step? |
| title_short | Evaluation of Baseline Characteristics and Prognostic Factors in Multisystemic Inflammatory Syndrome in Children: Is It Possible to Foresee the Prognosis in the First Step? |
| title_sort | evaluation of baseline characteristics and prognostic factors in multisystemic inflammatory syndrome in children is it possible to foresee the prognosis in the first step |
| topic | COVID-19 multisystem inflammatory syndrome in children (MIS-C) risk classification prognosis |
| url | https://www.mdpi.com/2077-0383/11/15/4615 |
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