Background

Inflammatory markers (IM) are measured commonly in febrile children. Their use has increased during the COVID-19 pandemic due to the risk of multisystem inflammatory syndrome (MIS-C). Little is known about changes in IM during acute Covid-19 infection, MIS-C, or other viral syndromes.

Aims

Compare IM levels in children with acute viral syndromes (AVS), COVID-19 and MIS-C.

Methods

We reviewed charts of 40 children admitted to JHS during July-August 2021 with fever. Tests were performed per standard protocol for evaluation of pediatric patients with fever and suspected MIS-C. Hospital course, treatments and discharge diagnoses were noted. Patients were grouped together as: testing positive for a virus other than SARS CoV-2 (AVS), positive SARS CoV-2 PCR (COVID-19), and if met CDC criteria for MIS-C and improved after anti-inflammatory treatment (MIS-C). Values are mean ± standard deviation and T-test.

Results

There were 26 males and 14 females. 17 children were diagnosed with AVS, 17 with COVID-19, and 6 with MIS-C. IM levels are shown in the table. There were no statistical differences between diagnostic groups of any IM.

Inflammatory markers in children with fever according to established diagnosis

Conclusions

1. Our preliminary data suggest routine IM screening cannot distinguish between AVS, Covid-19, and MIS-C.

2. MIS-C was characterized by a higher NT-proBNP, while ferritin was highest among children with AVS.

3. Further research is needed with more patients to better understand IM changes in febrile children.