Cardiac markers of multisystem inflammatory syndrome in children (MIS-C) in COVID-19 patients: A meta-analysis

Objective A meta-analysis of laboratory cardiac markers for multisystem inflammatory syndrome in children (MIS-C) was performed in patients with coronavirus disease 2019 (COVID-19) Methods Eight databases were searched until April 10, 2021, for studies on cardiac markers, including B-type natriuretic peptide (BNP)/N-terminal pro-BNP (NT-proBNP), troponin, aspartate aminotransferase (AST), in MIS-C patients Results Of the 2583 participants enrolled in 24 studies, 1613 patients were diagnosed with MIS-C MIS-C patients exhibited higher BNP levels than patients with non-severe COVID-19 [SMD (95% CI): 1 13 (0 48, 1 77), p < 0 05] No significant differences in BNP levels were observed between patients with MIS-C and severe COVID-19 [SMD (95% CI): 0 29 (−0 07, 0 65), p = 0 117] Comparisons of MIS-C patients to all COVID-19 patients revealed no significant differences in levels of troponin [SMD (95% CI): 0 13 (−0 07, 0 32), p = 0 212] or AST [SMD (95% CI): 0 10 (−0 11, 0 31), p = 0 336] Compared to patients with non-severe MIS-C, those with severe MIS-C exhibited higher levels of BNP [SMD (95% CI): 0 26 (0 04, 0 48), p < 0 05], but no differences in troponin [SMD (95% CI): 0 05 (−0 06, 0 16) p = 0 387] or AST [SMD (95% CI): 0 19 (−0 34, 0 71), p = 0 483] were observed Moreover, there was no significant difference in BNP [SMD (95% CI): −0 21 (−1 07, 0 64), p = 0 624] or troponin [SMD (95% CI): −0 07 (−0 45, 0 31), p = 0 710] between MIS-C with and without coronary artery abnormality Sensitivity analyses were performed to assess stability No publication bias was detected based on Begg's test Conclusions The key cardiac marker that showed differences between patients with MIS-C/non-severe COVID-19 and between patients with severe/non-severe MIS-C was BNP Other markers, such as troponin and AST, did not exhibit notable differences in indicating cardiac injury between patients with MIS-C and COVID-19