Prognostic significance of asymmetric dimethyl arginine level in pediatric patients with COVID-19 infection and MIS-C.

IF 3 3区 医学 Q1 PEDIATRICS European Journal of Pediatrics Pub Date : 2025-03-12 DOI:10.1007/s00431-025-06079-8
Memduha Sari, Fatih Akin, Abdullah Yazar, Ahmet Osman Kilic, Ozge Metin Akcan, Abdullah Akkus, Mehmet Uyar, Cemile Topcu, Mustafa Genceli
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Abstract

Coronavirus disease 2019 (COVID-19) and COVID-19-related multisystem inflammatory syndrome in children (MIS-C) is known to be a life-threatening health problem worldwide. The study investigates the potential relationship between asymmetric dimethylarginine (ADMA) levels and disease severity in such conditions. We conducted an observational, prospective study between July 2021 and January 2022. The study enrolled 98 patients diagnosed with COVID-19, 21 patients diagnosed with MIS-C, and 42 healthy individuals who served as a control group. The COVID-19 patients were further categorized into three subgroups based on their level of care: outpatients, those requiring hospitalization, and those requiring intensive care. The MIS-C patients formed a distinct fourth group. COVID-19 outpatients had a median ADMA level of 8097.0 ng/L (interquartile range: 6436.06-10840.0 ng/L), while those requiring hospitalization had a higher level of 13,195.60 ng/L (11,472.4-15,862.2 ng/L). Patients in intensive care exhibited the highest median ADMA level at 19,361.4 ng/L (15,596.65-23,367.9 ng/L). MIS-C patients also had elevated ADMA levels, with a median of 15,735.50 ng/L (13,486.6-20,532.5 ng/L). Receiver operating characteristic (ROC) curve analysis revealed that an ADMA level of 6135.15 ng/L could distinguish between patients and controls with 95% sensitivity, 100% specificity, 100% positive predictive value, and 87.5% negative predictive value.

Conclusions: In conclusion, our study is the first to investigate ADMA levels in children with COVID-19 and MIS-C. We found that ADMA levels were significantly elevated in children with COVID-19 requiring intensive care and those with MIS-C, suggesting a potential role for ADMA as a biomarker of endothelial dysfunction in these populations.

What is known: • Endothelial dysfunction is a determinant of poor prognosis in various cardiovascular diseases and plays a critical role in the pathogenesis of COVID-19 and MIS-C. • Asymmetric dimethylarginine (ADMA) is a well-known biomarker of endothelial dysfunction. Elevated levels of ADMA adversely affect vascular endothelial function by reducing nitric oxide production.

What is new: • It is the first to show that elevated ADMA levels in children with COVID-19 and MIS-C are associated with disease severity. • ADMA has been identified as a potential biomarker that can be used to assess the prognosis of COVID-19 and MIS-C in children and to predict the severity of the disease.

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来源期刊
CiteScore
5.90
自引率
2.80%
发文量
367
审稿时长
3-6 weeks
期刊介绍: The European Journal of Pediatrics (EJPE) is a leading peer-reviewed medical journal which covers the entire field of pediatrics. The editors encourage authors to submit original articles, reviews, short communications, and correspondence on all relevant themes and topics. EJPE is particularly committed to the publication of articles on important new clinical research that will have an immediate impact on clinical pediatric practice. The editorial office very much welcomes ideas for publications, whether individual articles or article series, that fit this goal and is always willing to address inquiries from authors regarding potential submissions. Invited review articles on clinical pediatrics that provide comprehensive coverage of a subject of importance are also regularly commissioned. The short publication time reflects both the commitment of the editors and publishers and their passion for new developments in the field of pediatrics. EJPE is active on social media (@EurJPediatrics) and we invite you to participate. EJPE is the official journal of the European Academy of Paediatrics (EAP) and publishes guidelines and statements in cooperation with the EAP.
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