Serum Vitamin D Levels in Relation to Development of Multisystem Inflammatory Syndrome in Pediatric COVID-19

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ZENGİN N., BAL A., Goren T. A., Bayturan S. S., ALKAN F., AKÇALI S.

Journal of Pediatric Infectious Diseases, cilt.17, sa.6, ss.308-316, 2022 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 17 Sayı: 6
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1055/s-0042-1756713
  • Dergi Adı: Journal of Pediatric Infectious Diseases
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CAB Abstracts, EMBASE, Veterinary Science Database
  • Sayfa Sayıları: ss.308-316
  • Anahtar Kelimeler: multisystem inflammatory syndrome, pediatric COVID-19, vitamin D, cardiac dysfunction, procalcitonin, prognostic scores
  • Manisa Celal Bayar Üniversitesi Adresli: Evet

Özet

Objective The aim of the study is to evaluate vitamin D (vit D) levels in children with and without development of multisystem inflammatory syndrome in children (MIS-C) after coronavirus disease 2019 (COVID-19) and also between those with severe and moderate MIS-C. Methods This comprises retrospective data of 68 patients including 34 patients with MIS-C and admitted into the pediatric intensive care unit (MIS-C group) and 34 patients without MIS-C (non-MIS-C group) were analyzed for their presenting characteristics, serum vit D levels, ventilatory needs, and prognostic scores. Results Vit D levels were significantly lower in patients with versus without MIS-C [9 (2-18) vs. 19 (10-43) ng/mL, p <0.001], and also in patients with severe versus moderate MIS-C [7.5 (2-17) vs. 9 (5-18) ng/mL, p = 0.024]. Vit D deficiency (levels <12 ng/mL) was more common in the MIS-C versus non-MIS-C group (79.4 vs. 11.8%, p <0.001) and in severe versus moderate MIS-C (92.9 vs. 70.0%, p <0.001). The severe versus moderate MIS-C was associated with significantly higher levels of procalcitonin [7.6 (0.9-82) vs. 1.7 (0.2-42) ng/mL, p = 0.030] and troponin [211 (4.8-4,545) vs. 14.2 (2.4-3,065) ng/L, p = 0.008] and higher likelihood of reduced ejection fraction (75.0 vs. 15.4%, p = 0.004). Conclusion Our findings indicate the higher prevalence of vit D deficiency in pediatric COVID-19 patients with versus without MIS-C, as well as in those with severe versus moderate MIS-C. Higher troponin and procalcitonin levels and dyspnea at presentation seem also to be risk factors for severe MIS-C, more pronounced cardiac dysfunction, and poorer prognosis.