ArticleJournal of multidisciplinary healthcare2025
Prognostic Value of Caspase-3 and Cardiac Troponin I in Assessing Cardiovascular Risk in Pediatric COVID-19 and Multisystem Inflammatory Syndrome.
Article in Journal of multidisciplinary healthcare, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: The studies of COVID-19-related cardiovascular events in children are not widespread. Criteria for cardiovascular dysfunction have been explicitly proposed for multisystem inflammatory syndrome in children (MIS-C), while for other COVID-19 manifestations, it remains unclear. Although instrumental confirmation of cardiovascular injury is well-known, laboratory markers for such injuries have not been thoroughly studied. Our study aimed to identify prognostic cut-off values for caspase-3 and cardiac troponin I (cTI) to define cardiovascular injury in pediatric COVID-19 patients during acute infection and MIS-C. Patients and Methods: A cross-sectional study was conducted in Ternopil, Ukraine, involving two hundred sixty children aged one month to 17 years who had not previously been vaccinated against SARS-CoV-2. The research focused on different severities of COVID-19: mild (n=87); moderate (n=66); severe COVID-19 (n=22); MIS-C (n=40) and 45 non-SARS-CoV-2 infected persons. ELISA tests were used to measure caspase-3 and cardiac troponin I levels. Results: Caspase-3 and cTI levels were significantly higher in patients with severe COVID-19 and MIS-C compared to non-infected individuals. Furthermore, COVID-19 and MIS-C patients with cardiac abnormalities had substantially higher levels of caspase-3 and cTI compared to those without structural changes. The study also revealed a positive correlation between caspase-3 and cardiac troponin I levels in both the COVID-19 group (r = 0.41; p < 0.05) and the MIS-C group (r = 0.55; p < 0.05). The study has identified specific cut-off values for caspase-3 and cTI that can be used to predict cardiovascular structural changes in pediatric patients with COVID-19 and MIS-C. These values are caspase-3 ≥ 5.22 ng/mL, cTI≥ 1.34 ng/mL for COVID-19, and caspase-3 ≥ 6.52 ng/mL and cTI ≥ 0.39 ng/mL for MIS-C. Conclusion: Current research has demonstrated that children with severe COVID-19, as well as patients with MIS-C, must undergo careful screening for cardiovascular events that could include biomarkers.
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