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Age-adjusted NT-proBNP could help in the early identification and follow-up of children at risk for severe multisystem inflammatory syndrome associated with covid-19(MIS-C)

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World Journal of Clinical Cases 2022年第29期10卷 10435-10450页

作者： Moises Rodriguez-Gonzalez Ana Castellano-Martinez Division of Pediatric Cardiology Puerta del Mar University HospitalCadiz 11009Spain Division of Pediatric Nephrology Puerta del Mar University HospitalCadiz 11009Spain

BACKGROUND multisystem inflammatory syndrome in children(MIS-C) has emerged as a new disease associated with covid-19 that presents in acute critically ill children with acute cardiovascular *** To determine whether the age-adjusted N-terminal pro-brain natriuretic peptide(NT-proBNP) value(Z-log-NT-proBNP) is associated with severe MIS-C and myocardial *** A retrospective study was conducted which included children with MIS-C managed at our institution between April 1,2020,and February 28,*** divided the population into groups depending on severity based on pediatric intensive care unit(PICU) *** compared Z-log-NT-proBNP values across these groups and analyzed Z-log-NT-proBNP dynamics during the onemonth *** We included 17 participants [median age 3(2-9) years] and seven(41%) required PICU ***(100%) of these cases presented very high(Z-log > 4) levels of NT-proBNP at the time of admission compared to only 5(50%) patients with non-severe MIS-C(P = 0.025).NT-proBNP was significantly correlated with highsensitive Troponin I levels(P = 0.045),Ross modified score(P = 0.003) and left ventricle ejection fraction(P = 0.021).CONCLUSION Raised NT-proBNP,specifically very high values(Z-log-NT-proBNP > 4) could help in the early identification of MIS-C patients with myocardial dysfunction requiring inotropic support and PICU admission.

关键词： multisystem inflammatory syndrome associated with covid-19 covid-19 SARS-CoV-2 NT-proBNP Echocardiography Myocardial dysfunction Children

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