Inflammatory and coagulation marker profiles in severe pediatric COVID-19 patients: a systematic review
Keywords:
inflammatory marker; coagulation marker; severe pediatric COVID-19
Abstract
Background Children are susceptible to SARS-CoV-2 infection and often present mild manifestations. However, severe and critical cases have also been reported. The inflammation and coagulation marker profile pattern in these patients along with the white blood cell differential count in critical PICU cases with non-COVID-19 etiology is not entirely clear.
Objective To evaluate the inflammation and coagulation profiles in children presenting with severe/critical SARS-CoV-2 infection.
Methods A systematic search and review of scientific literature was conducted following the PRISMA guidelines using ProQuest, SCOPUS, EBSCOHost, ScienceDirect, Cochrane, EMBASE, and Pubmed databases. All relevant original studies until March 11, 2021, were included. The risk of bias was appraised using the Modified Newcastle Ottawa Scale and JBI Critical Appraisal Checklist tools.
Results We identified 14 studies across 6 countries, including a total sample of 159 severe and critically ill pediatric COVID-19 patients. Most of the subjects showed normal leukocytes, but increased CRP, procalcitonin, ferritin, and IL-6. Studies on coagulation profiles showed normal thrombocytes, PT, aPTT, and inconsistent D-dimer results.
Conclusion Inflammation and coagulation parameters in severe/critically ill children with COVID-19 are atypical. Several inflammatory markers were elevated, including CRP, ferritin, procalcitonin, and IL-6. However, the elevated marker values are still lower compared to non-COVID infection patients. Further investigation of the parameters need to be done in serial examination multicenter studies, which include control subjects.
References
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16. Lu W, Lu W, Yang L, Yang L, Li X, Li X et al. Early Immune Responses and Prognostic Factors in Children with COVID-19: A Single-center Retrospective Analysis. 2020;. DOI: https://doi.org/10.21203/rs.3.rs-101151/v1.
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18. Zachariah P, Johnson C, Halabi K, Ahn D, Sen A, Fischer A et al. Epidemiology, Clinical Features, and Disease Severity in Patients With Coronavirus Disease 2019 (COVID-19) in a Children’s Hospital in New York City, New York. JAMA Pediatrics. 2020;174):e202430. DOI: https://doi.org/10.1001/jamapediatrics.2020.2430.
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21. Wang Y, Zhu F, Wang C, Wu J, Liu J, Chen X et al. Children Hospitalized With Severe COVID-19 in Wuhan. Pediatric Infectious Disease Journal. 2020;39:e91-e94. DOI: https://doi.org/10.1097/inf.0000000000002739.
22. Ozenen G, Sahbudak Bal Z, Umit Z, Bilen N, Yildirim Arslan S, Yurtseven A et al. Demographic, clinical, and laboratory features of COVID?19 in children: The role of mean platelet volume in predicting hospitalization and severity. Journal of Medical Virology. 2021;. DOI: https://doi.org/10.1002/jmv.26902.
23. Du H, Dong X, Zhang J, Cao Y, Akdis M, Huang P et al. Clinical characteristics of 182 pediatric COVID?19 patients with different severities and allergic status. Allergy. 2020;76:510-32. DOI: https://doi.org/10.1111/all.14452.
24. Zheng F, Liao C, Fan Q, Chen H, Zhao X, Xie Z et al. Clinical Characteristics of Children with Coronavirus Disease 2019 in Hubei, China. Current Medical Science. 2020;40:275-80. DOI: https://doi.org/10.1007/s11596-020-2172-6.
25. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395:1054-62. DOI: https://doi.org/10.1016/S0140-6736(20)30566-3.
26. Peckham H, Gruijter NM, Raine C, Radziszewska A, Clurtin C, Wedderburn L, et al. Male sex identified by global COVID-19 meta-analysis as a risk factor for death and ITU admission 2020;11:6317. DOI: https://doi.org/10.1038/s41467-020-19741-6.
27. Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med. 2020;46:846–8. DOI: https://doi.org/10.1007/s00134-020-05991-x.
28. Zachariah P, Johnson CL, Halabi KC, Ahn D, Sen AI, Fischer A, et al. Epidemiology, clinical features, and disease severity in patients with Coronavirus disease 2019 (COVID-19) in a children’s hospital in New York City, New York. JAMA Pediatr. 2020;174:e202430. DOI: https://doi.org/10.1001/jamapediatrics.2020.2430.
29. Carcillo JA, Sward K, Halstead ES, Telford R, Jimenez-Bacardi A, Shakoory B, et al. A systemic inflammation mortality risk assessment contingency table for severe sepsis. Pediatr Crit Care Med. 2017;18:143–50. DOI: https://doi.org/10.1097/PCC.0000000000001029.
30. Khattab AA, El- Mekkawy MS, Shehatab AM, Whdan NA. Clinical study of serum interleukin-6 in children with community-acquired pneumonia. Egyptian Pediatric Association Gazette. 2018;66:43-8. DOI: https://doi.org/10.1016/j.epag.2018.03.003.
31. Guervilly C, Coisel Y, Botelho-Nevers E, Dizier S, Castanier M, Lepaul-Ercole R, et al. Significance of high levels of procalcitonin in patients with influenza A (H1N1) pneumonia. J Infect. 2010;61:355–8. DOI: https://doi.org/10.1016/j.jinf.2010.07.013.
32. Almazeedi S, Al-Youha S, Jamal MH, Al-Haddad M, Al-Muhaini A, Al-Ghimlas F, et al. Characteristics, risk factors and outcomes among the first consecutive 1096 patients diagnosed with COVID-19 in Kuwait. EClinicalMedicine. 2020;24:100448. DOI: https://doi.org/10.1016/j.eclinm.2020.100448.
33. Leteurtre S, Duhamel A, Salleron J, Grandbastien B, Lacroix J, Leclerc F, et al. PELOD-2: an update of the PEdiatric logistic organ dysfunction score. Crit Care Med. 2013;41:1761–73. DOI: https://doi.org/10.1097/CCM.0b013e31828a2bbd.
34. Carcillo J, Halstead ES, Hall M W, Nguyen TC, Reeder R, Aneja R, et al. Three hypothetical inflammation pathobiology phenotypes and pediatric sepsis-induced multiple organ failure outcomes. Pediatr Crit Care Med. 2017;18: 513–3. DOI: https://doi.org/10.1097/PCC.000000000000112230.Cao B, Li XW, Mao Y, Wang J, Lu HZ, Chen YS, et al. Clinical features of the initial cases of 2009 pandemic influenza A (H1N1) virus infection in China. N Engl J Med. 2009;361:2507–17. DOI: https://doi.org/10.1056/NEJMoa090661.
35. Russell CD, Parajuli A, Gale HJ, Bulteel NS, Schuetz P, de Jager CPC, et al. The utility of peripheral blood leucocyte ratios as biomarkers in infectious diseases: a systematic review and meta-analysis. J Infect. 2019;78:339-48. DOI: https://doi.org/10.1016/j.jinf.2019.02.006.
36. Jesenak M, Brndiarova M, Urbancikova I, Rennerova Z, Vojtkova J, Bobcakova A, et al. Immune parameters and COVID-19 infection - associations with clinical severity and disease prognosis. Front Cell Infect Microbiol 2020;10:364. DOI: https://doi.org/10.3389/fcimb.2020.00364.
37. Huang CL, Wang YM, Li XW, Ren LL, Zhao JP, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497 –506. DOI: https://doi.org/10.1016/S0140-6736(20)30183-5.
38. Dhar SK, K V, Damodar S, Gujar S, Das M. IL-6 and IL-10 as predictors of disease severity in COVID-19 patients: results from meta-analysis and regression. Heliyon. 2021;7(2): e06155. DOI: https://doi.org/10.1016/j.heliyon.2021.e06155.
39. Li L, Li J, Gao M, Fan H, Wang Y, Xu X, et al. Interleukin-8 as a biomarker for disease prognosis of coronavirus disease-2019 patients. Frontiers in Immunology. 2021;11: 602395. DOI: https://doi.org/10.3389/fimmu.2020.602395.
Published
2022-12-15
How to Cite
1.
Fathan T, Pudjiadi A, Putri N, Permata N, Nursakina Y. Inflammatory and coagulation marker profiles in severe pediatric COVID-19 patients: a systematic review. PI [Internet]. 15Dec.2022 [cited 23Nov.2024];62(6):411-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/2815
Section
Emergency & Pediatric Intensive Care
Copyright (c) 2022 Tartila Fathan
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Received 2021-10-19
Accepted 2022-12-15
Published 2022-12-15
Accepted 2022-12-15
Published 2022-12-15
