Platelet role in the prediction of MIS-C severity

Ausra Snipaitiene; Aurelija Sirataviciene; Leila Varoneckaite; Rima Sileikiene; Lina Jankauskaite

doi:10.3389/fped.2023.1153623

Platelet role in the prediction of MIS-C severity

Front Pediatr. 2023 Jun 8:11:1153623. doi: 10.3389/fped.2023.1153623. eCollection 2023.

Authors

Ausra Snipaitiene^{1

2}, Aurelija Sirataviciene^{1

2}, Leila Varoneckaite^{1

2}, Rima Sileikiene^{1

2}, Lina Jankauskaite^{1

2

3}

Affiliations

¹ Pediatric Department, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
² Pediatric Department, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Kaunas, Lithuania.
³ Institute of Physiology and Pharmacology, Lithuanian University of Health Sciences, Kaunas, Lithuania.

Abstract

Introduction: Multisystem inflammatory syndrome in children (MIS-C) has been reported as one of the cytokine storm syndromes associated with COVID-19. Despite the several proposed diagnostic criteria, MIS-C remains a diagnostic and clinical challenge. Recent studies have demonstrated that platelets (PLTs) play a crucial role in COVID-19 infection and its prognosis. This study aimed to investigate the clinical importance of PLT count and PLT indices in predicting MIS-C severity in children.

Patients and methods: We conducted a retrospective single-center study at our university hospital. A total of 43 patients diagnosed with MIS-C during a 2-year period (from October 2020 to October 2022) were included in the study. MIS-C severity was evaluated according to the composite severity score.

Results: Half of the patients were treated in the pediatric intensive care unit. No single clinical sign was associated with a severe condition, except for shock (p = 0.041). All the routine biomarkers, such as complete blood count (CBC) and C-reactive protein (CRP), used for MIS-C diagnosis were significant in predicting MIS-C severity. Single PLT parameters, such as mean PLT volume, plateletcrit, or PLT distribution width, did not differ between the severity groups. However, we found that a combination of PLT count and the previously mentioned PLT indices had the potential to predict MIS-C severity.

Conclusions: Our study emphasizes the importance of PLT in MIS-C pathogenesis and severity. It revealed that together with routine biomarkers (e.g., CBC and CRP), it could highly improve the prediction of MIS-C severity.

Keywords: COVID-19; biomarker; children; multisystem inflammatory syndrome in children; platelets.