The Inflammatory Markers of Multisystem Inflammatory Syndrome in children (MIS-C) and Adolescents During the COVID-19 Pandemic: A Meta-Analysis (preprint)

ABSTRACT

As per the indicated need in literature, we conducted a systematic review and meta-analysis to characterize inflammatory markers of MIS-C patients with COVID-19, Kawasaki disease (KD), and coronary artery abnormalities. We searched nine databases for studies on inflammatory markers of MIS-C. After quality check, data were pooled using a fixed- or random-effects model. Inflammatory markers included white blood cell count (WBC) or leukocytes, absolute lymphocyte count (ALC), absolute neutrophil count (ANC), platelet count (PLT), C-reactive protein (CRP), procalcitonin (PCT), ferritin, D-dimer, lactate dehydrogenase (LDH), fibrinogen and erythrocyte sedimentation rate (ESR) for comparisons by severity and age. Twenty studies with 2,990 participants yielded 684 MIS-C patients. Compared to non-severe COVID-19 patients, MIS-C patients had lower ALC and higher ANC, CRP and D-dimer levels. Compared to severe COVID-19 patients, MIS-C patients had lower LDH and PLT counts and higher ESR levels. Compared to KD patients, MIS-C patients had lower ALC and PLT, and higher CRP and ferritin levels. Severe MIS-C patients had higher levels of WBC, CRP, D-dimer and ferritin. For MIS-C, younger children had lower CRP and ferritin levels than medium-aged/older children. Measurement of inflammatory markers might assist clinicians in accurate evaluation and diagnosis of MIS-C and the associated disorders.