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J Pediatr Infect Dis 2022; 17(06): 308-316
DOI: 10.1055/s-0042-1756713
Original Article

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

Neslihan Zengin 
1   Division of Pediatric Intensive Care, Department of Pediatrics, Celal Bayar University Faculty of Medicine, Manisa, Turkey
,
Alkan Bal 
2   Division of Pediatric Emergency Care, Department of Pediatrics, Celal Bayar University Faculty of Medicine, Manisa, Turkey
,
Tugba Aysun Goren 
3   Department of Pediatrics, Celal Bayar University Faculty of Medicine, Manisa, Turkey
,
Semra Sen Bayturan 
4   Division of Pediatric Infectious Diseases, Department of Pediatrics, Celal Bayar University Faculty of Medicine, Manisa, Turkey
,
Fatos Alkan 
5   Division of Pediatric Cardiology, Department of Pediatrics, Celal Bayar University Faculty of Medicine, Manisa, Turkey
,
Sinem Akcali 
6   Department of Microbiology, Celal Bayar University Faculty of Medicine, Manisa, Turkey
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Abstract

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.

Keywords

multisystem inflammatory syndrome - pediatric COVID-19 - vitamin D - cardiac dysfunction - procalcitonin - prognostic scores


Publikationsverlauf

Eingereicht: 19. Mai 2022

Angenommen: 08. August 2022

Artikel online veröffentlicht:
04. Oktober 2022

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