Cardiovascular system damage in children with COVID-19
DOI:
https://doi.org/10.15574/SP.2023.133.6Keywords:
COVID-19, cardiovascular system, E-selectin, children, marker, complicationsAbstract
Purpose - to assess the diagnostic and prognostic value of the E-selectin marker in relation to manifestations of damage to the cardiovascular system in children with COVID-19.
Materials and methods. We conducted a cohort, observational, retrospective study involving 88 patients aged 1 month to 18 years with laboratory-confirmed COVID-19 by polymerase chain reaction. The children were hospitalized in Kyiv City Children’s Clinical Infectious Disease Hospital. We divided the examined cohort into two groups according to the course of the disease - the main group, which included 42 patients with a complicated course of COVID-19, and the control group - 46 patients with an uncomplicated course of the disease. In the study, we took into account the data of ECG, patient complaints and clinical symptoms. During the comprehensive examination of the patients on the first day of their stay in the hospital, the blood serum of the patients was collected for the purpose of its further examination for the level of E-selectin by enzyme immunoassay. Statistical, analytical methods and the method of empirical research were used in the research. To calculate the obtained results, we used the statistical program “Statistical software EZR v. 1.54”.
Results. In patients of the control group, E-selectin was observed at the level of 12.02±1.7 ng/ml, while in the children of the main one, the indicator was higher, it was 15.04±1.9 ng/ml (p=0.034). According to the assessment of the prognostic value, we found that an increase in the level of E-selectin above 10 ng/ml is associated with a significant increase in the risk of the appearance of clinical symptoms of the cardiovascular system in children with COVID-19 (p<0.05). We also noted a tendency for the marker to grow with objective changes on the ECG.
Conclusions. We discovered the diagnostic and prognostic value of the E-selectin marker in children with COVID-19 regarding the manifestations of damage to the cardiovascular system in children with COVID-19. An increase in the level of E-selectin above 10 ng/ml is associated with a significant increase in the risk of the appearance of clinical symptoms of damage to the cardiovascular system (p<0.05) and objective changes during instrumental examination (p<0.1).
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. Written consent from patients was not required, as the study is retrospective and uses data from routine medical records.
No conflict of interests was declared by the authors.
References
Ahmed S, Zimba O, Gasparyan AY. (2020). Thrombosis in Coronavirus disease 2019 (COVID-19) through the prism of Virchow's triad. Clin. Rheumatol. 39: 2529-2543. https://doi.org/10.1007/s10067-020-05275-1; PMid:32654082 PMCid:PMC7353835
Bikdeli B, Madhavan MV, Jimenez D, Chuich T, Dreyfus I, Driggin E et al. (2020). COVID-19 and thrombotic or thromboembolic disease: implications for prevention, antithrombotic therapy, and follow-up. J Am Coll Cardiol. 75: 2950-2973. https://doi.org/10.1016/j.jacc.2020.04.031; PMid:32311448 PMCid:PMC7164881
Centers for Disease Control and Prevention. (2023). Health Department-Reported Cases of Multisystem Inflammatory Syndrome in Children (MIS-C) in the United States. URL: https://covid.cdc.gov/covid-data-tracker/#mis-national-surveillance.
Colantuoni A, Martini R, Caprari P et al. (2020). COVID-19 Sepsis and Microcirculation Dysfunction. Frontiers in Physiology. 11: 747. https://doi.org/10.3389/fphys.2020.00747; PMid:32676039 PMCid:PMC7333313
Dong Y, Mo X, Hu Y et al. (2020). Epidemiological characteristics of 2143 pediatric patients with 2019 coronavirus disease in China. Pediatrics. URL: https://www.accesocovid.com/blog-posts-english/epidemiological-characteristics-of-2143-pediatric-patients-with-2019-coronavirus-disease-in-china.
Eikendal ALM, Bots ML, Gohar A et al. (2018). Circulating levels of P-selectin and E-selectin relate to cardiovascular magnetic resonance-derived aortic characteristics in young adults from the general population, a cross-sectional study. J Cardiovasc Magn Reson. 20: 54. https://doi.org/10.1186/s12968-018-0473-8; PMid:30068374 PMCid:PMC6090925
Eric Yuk Fai Wan et al. (2023). Association of COVID-19 with short- and long-term risk of cardiovascular disease and mortality: a prospective cohort in UK Biobank, Cardiovascular Research. 195; 8: 1718-1727. https://doi.org/10.1093/cvr/cvac195; PMid:36652991
Guo T, Fan Y, Chen M, Wu X, Zhang L, He T et al. (2020). Cardiovascular Implications of Fatal Outcomes of Patients with Coronavirus Disease 2019 (COVID-19). JAMA Cardiol. 5: 1-8. https://doi.org/10.1001/jamacardio.2020.1017; PMid:32219356 PMCid:PMC7101506
Gupta A, Madhavan MV, Sehgal K et al. (2020). Extrapulmonary manifestations of COVID-19. Nat Med. 26: 1017-1032. https://doi.org/10.1038/s41591-020-0968-3; PMid:32651579
Guzik TJ, Mohiddin SA, Dimarco A, Patel V, Savvatis K, et al. (2020). COVID-19 and the cardiovascular system: implications for risk assessment, diagnosis, and treatment options. Cardiovasc Res. 116 (10): 1666-1687. https://doi.org/10.1093/cvr/cvaa106; PMid:32352535 PMCid:PMC7197627
Huang RB, Eniola-Adefeso O. (2012). Shear stress modulation of IL-1β-induced E-selectin expression in human endothelial cells. PLoS One. 7 (2): e31874. https://doi.org/10.1371/journal.pone.0031874; PMid:22384091 PMCid:PMC3286450
Khodabandehlou K, Masehi-Lano J, Poon C, Wang J, Chung EJ. (2017). Targeting cell adhesion molecules with nanoparticles using in vivo and flow-based in vitro models of atherosclerosis. Exp Biol Med (Maywood). 242 (8): 799-812. https://doi.org/10.1177/1535370217693116; PMid:28195515 PMCid:PMC5407539
Khodak LA, Ohiyenko VI, Bilokonova LA, Deyneka NH. (2020). Osoblyvosti novoyi koronavirusnoyi infektsiyi COVID-19 u ditey. Infektsiyni khvoroby. 4 (102): 41-47. https://doi.org/10.11603/1681-2727.2020.4.11895
Lakkireddy DR, Chung MK, Gopinathannair R, Patton KK, Gluckman TJ et al. (2020). Guidance for cardiac electrophysiology during the coronavirus (COVID-19) pandemic from the Heart Rhythm Society COVID-19 Task Force; Electrophysiology Section of the American College of Cardiology; and the Electrocardiography and Arrhythmias Committee of the Council on Clinical Cardiology, American Heart Association. Heart Rhythm. S1547-5271: 30289-30297. https://doi.org/10.1016/j.hrthm.2020.03.028; PMid:32247013 PMCid:PMC7118697
Oliva A, Rando E, Al Ismail D, De Angelis M, Cancelli F et al. (2021). Role of Serum E-Selectin as a Biomarker of Infection Severity in Coronavirus Disease 2019. J Clin Med. 10 (17): 4018. https://doi.org/10.3390/jcm10174018; PMid:34501466 PMCid:PMC8432564
Rodriguez-Gonzalez M, Castellano-Martinez A, Cascales-Poyatos HM, Perez-Reviriego AA. (2020). Cardiovascular impact of COVID-19 with a focus on children: a systematic review. World J Clin Cases. 8: 5250-5283. https://doi.org/10.12998/wjcc.v8.i21.5250; PMid:33269260 PMCid:PMC7674714
Schutzman LM, Rigor RR, Khosravi N, Galante JM, Brown IE. (2019). P-selectin is critical for de novo pulmonary arterial thrombosis following blunt thoracic trauma. J Trauma Acute Care Surg. 86 (4): 583-591. https://doi.org/10.1097/TA.0000000000002166; PMid:30562326
Simpson M, Collins C, Nash DB, Panesar LE, Oster ME. (2020). Coronavirus disease 2019 infection in children with pre-existing heart disease. J Pediatr. 227: 302-307.e2. https://doi.org/10.1016/j.jpeds.2020.07.069; PMid:32730815 PMCid:PMC7384421
Smadja DM, Guerin CL, Chocron R, Yatim N, Boussier J et al. (2020). Angiopoietin-2 as a marker of endothelial activation is a good predictor factor for intensive care unit admission of COVID-19 patients. Angiogenesis. 23 (4): 611-620. https://doi.org/10.1007/s10456-020-09730-0; PMid:32458111 PMCid:PMC7250589
Smith CW. (2008). Adhesion molecules and receptors. J Allergy Clin Immunol. 121 (2): S375-S379: quiz S414. https://doi.org/10.1016/j.jaci.2007.07.030; PMid:18241685
Son MB, Friedman K, Fulton DR, Kaplan SL, Sundel R et al. (2023). COVID-19: Multisystem inflammatory syndrome in children (MIS-C) clinical features, evaluation, and diagnosis. UptoDate. URL: https://www.uptodate.com/contents/covid-19-multisystem-inflammatory-syndrome-in-children-mis-c-clinical-features-evaluation-and-diagnosis#disclaimerContent.
Sundd P, Pospieszalska MK, Cheung LS, Konstantopoulos K, Ley K. (2011). Biomechanics of leukocyte rolling. Biorheology. 48 (1): 1-35. https://doi.org/10.3233/BIR-2011-0579; PMid:21515934 PMCid:PMC3103268
Varga Z, Flammer AJ, Steiger P et al. (2020). Endothelial cell infection and endotheliitis in COVID-19. The Lancet. 395 (10234): 1417-1418. https://doi.org/10.1016/S0140-6736(20)30937-5; PMid:32325026
Vassiliou AG, Keskinidou C, Jahaj E, Gallos P, Dimopoulou I et al. (2021). ICU Admission Levels of Endothelial Biomarkers as Predictors of Mortality in Critically Ill COVID-19 Patients. Cells. 10 (1): 186. https://doi.org/10.3390/cells10010186; PMid:33477776 PMCid:PMC7832393
Voronkov LH, Ryabenko DV. (2021). Urazhennya sertsya, pov'yazani z COVID-19: diahnostyka ta likuvannya. Zdorov'ya Ukrayiny ХХІ storichchya. 7 (500): 13-14.
Watany MM, Abdou S, Elkolaly R et al. (2022). Evaluation of admission levels of P, E and L selectins as predictors for thrombosis in hospitalized COVID-19 patients. Clin Exp Med. 22: 567-575. https://doi.org/10.1007/s10238-021-00787-9; PMid:35061142 PMCid:PMC8778493
Whittaker E, Bamford A, Kenny J, Kaforou M, Jones CE et al. (2020). PIMS-TS Study Group and EUCLIDS and PERFORM Consortia. Clinical characteristics of 58 children with a pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2. JAMA. 324: 259-269. https://doi.org/10.1001/jama.2020.10369; PMid:32511692 PMCid:PMC7281356
World Health Organization. (2023). WHO Coronavirus (COVID-19) Dashboard. URL: https://covid19.who.int/.
Yasuhara J, Watanabe K, Takagi H, Sumitomo N, Kuno T. (2021). COVID-19 and multisystem inflammatory syndrome in children: a systematic review and meta-analysis. Pediatr Pulmonol. 56: 837-848. https://doi.org/10.1002/ppul.25245; PMid:33428826 PMCid:PMC8013394
Ye Q, Wang B, Mao J. (2020). The pathogenesis and treatment of the 'Cytokine Storm' in COVID-19. J Infect. 80: 607-613. https://doi.org/10.1016/j.jinf.2020.03.037; PMid:32283152 PMCid:PMC7194613
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Modern pediatrics. Ukraine
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The policy of the Journal “MODERN PEDIATRICS. UKRAINE” is compatible with the vast majority of funders' of open access and self-archiving policies. The journal provides immediate open access route being convinced that everyone – not only scientists - can benefit from research results, and publishes articles exclusively under open access distribution, with a Creative Commons Attribution-Noncommercial 4.0 international license (СС BY-NC).
Authors transfer the copyright to the Journal “MODERN PEDIATRICS. UKRAINE” when the manuscript is accepted for publication. Authors declare that this manuscript has not been published nor is under simultaneous consideration for publication elsewhere. After publication, the articles become freely available on-line to the public.
Readers have the right to use, distribute, and reproduce articles in any medium, provided the articles and the journal are properly cited.
The use of published materials for commercial purposes is strongly prohibited.
