Assessment of Serum Pentraxin 3 Level in Critically Ill Pediatric Patients with COVID 19 Infection and Multisystem Inflammatory Syndrome in Children (MIS-C) Related to COVID 19
Authors: El-Ramady Nehad Mohamed , Ibrahim Hanan Mohamed , El- Mohamdy Marwa Adham , Magdy Sondos Mohamed 
Published: November 2024

Abstract

Background
Multisystem Inflammatory Syndrome in Children (MIS-C) is a rare but severe condition that has been observed in pediatric patients following COVID-19 infection. The identification of prognostic markers for MIS-C is crucial for early detection and appropriate management. Two potential prognostic markers that have been studied in relation to MIS-C are pentraxin 3 (PTX3) and procalcitonin.

Aim
To assess serum Pentraxin 3 level in COVID-19 infection pediatric patients and Multisystem Inflammatory Syndrome in Children (MIS-C) related to COVID-19.

Methods
This is a cohort study consisting of (75) children, joined through consecutive method. They were assigned into 3 groups, pediatric patients with COVID-19, Pediatric patients with MIS-C related to COVID-19, as well as healthy controls matching age and gender in both groups. In addition, patients were mainly assessed for serum Pentraxin 3, and Serum Procalcitonin levels by ELISA.

Results
we included 28 patients in the Covid-19 group, and 29 patients in the MIS-C group with median age of 31.5 months, and 84 months, respectively. We found that the median Pentraxin 3 (PTX3), and Procalcitonin (PCT) levels were significantly higher in the Covid 19 group than the MISC and control groups with values of (11.8 ng/mL), (5.2 ng/mL), and (1.5 ng/mL), respectively; and (799.6 ng/mL), (691.6 ng/mL), and (0.03 ng/mL), respectively. As regards vital signs in the two groups, MIS-C patients had significantly higher temperature, and oxygen saturation with (38.45 °C vs. 37.70 °C), and (98.48% vs. 95.32%), respectively. Regarding laboratory investigations, Ferritin, and CRP, MIS-C group had significantly higher values with (743 vs 290 µg/L), and (188, and 38), respectively. As regards correlation between Pentraxin 3 (PTX3), and Procalcitonin (PCT) with symptoms and laboratory investigations in the MIS-C group, PTX3 showed significant positive correlation with dehydration, hypotension, and creatinine level, (R = 0.108, 0.128, and 0.106), and (P = 0.001, 0.022, and 0.048), respectively. While Procalcitonin (PCT) showed significant positive correlation with dehydration, and Sequential Organ Failure Assessment (SOFA score) (R = 0.439, and 0.4), and (P = 0.036, and 0.032), respectively, in addition, it showed significant negative correlation with EF% (R=-0.511), and (P = 0.005). Regarding correlation between Pentraxin 3 (PTX3), and Procalcitonin (PCT) with symptoms and laboratory investigations in the Covid-19 group, they both had positive correlation duration of fever (R = 0.433, and 0.108), and (P = 0.021, and 0.585). On the other hand, oxygen saturation demonstrated an inverse correlation with Procalcitonin R=-0.376), and (P = 0.049), but not with Pentraxin 3.

Conclusion
it’s concluded that PTX3, and PCT levels significantly increase in Covid-19 patients, and MIS-C patients. Not only that, but they are significantly higher in the Covid-19 group than the MIS-C group.