Rodriguez-Gonzalez M, Castellano-Martinez A. 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). World J Clin Cases 2022; 10(29): 10435-10450 [PMID: 36312492 DOI: 10.12998/wjcc.v10.i29.10435]
Corresponding Author of This Article
Ana Castellano-Martinez, MD, Doctor, Research Scientist, Division of Pediatric Nephrology, Puerta del Mar University Hospital, Ana de Viya Avenue 21st, Cadiz 11009, Spain. anacastellanomartinez@gmail.com
Research Domain of This Article
Pediatrics
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Oct 16, 2022; 10(29): 10435-10450 Published online Oct 16, 2022. doi: 10.12998/wjcc.v10.i29.10435
Table 1 World Health Organization case definition for Multisystem inflammatory syndrome in children
All criteria must be met
Age 0 to 19 yr
Fever ≥ 3 d
Clinical signs of multisystem involvement (at least 2 of the following):
Rash, bilateral non purulent conjunctivitis, or mucocutaneous inflammation (oral, hands, or feet)
Hypotension or shock
Cardiac dysfunction, pericarditis, valvulitis, or coronary abnormalities (including echocardiographic findings or elevated troponin/BNP)
Evidence of coagulopathy (prolonged PT or PTT; elevated D-dimer)
Acute gastrointestinal symptoms (diarrhea, vomiting, or abdominal pain)
Elevated markers of inflammation (e.g., ESR, CRP, or procalcitonin)
No other obvious microbial cause of inflammation, including bacterial sepsis and staphylococcal/streptococcal toxic shock syndromes
Evidence of SARS-CoV-2 infection with any of the following:
Positive SARS-CoV-2 RT-PCR
Positive serology
Positive antigen test
Contact with an individual with COVID-19 either laboratory confirmation of SARS-CoV-2 infection by RT-PCR, serology, or antigen test, or known COVID-19 exposure within 4 weeks before symptom onset
Table 2 Demographic data and clinical presentation of the study population
Table 6 Comparison of clinical, laboratory and echocardiographic characteristics according to the need of pediatric intensive care unit admission and inotropic support during hospitalization
Table 7 Correlation analysis of the relationship between N-terminal pro-brain natriuretic peptide and all the cardiac continuous variables explored in this study
NT-proBNP (Z-log value adjusted for age)
Correlation coefficient
P value
hs-TnI (ng/L)
0.47
0.045
Age-based Ross score for heart failure
0.76
0.003
LVEF (%)
-0.55
0.021
Maximal CA diameter
-0.21
NS.
Citation: Rodriguez-Gonzalez M, Castellano-Martinez A. 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). World J Clin Cases 2022; 10(29): 10435-10450