Cardiac Manifestations and Emerging Biomarkers in Multisystem Inflammatory Syndrome in Children (MIS-C): A Systematic Review and Meta-Analysis
Background: Cardiac involvement is a key prognostic factor in multisystem inflammatory syndrome in children (MIS-C), a rare but serious inflammatory condition that typically occurs 2–6 weeks after SARS-CoV-2 infection and is characterized by fever, systemic inflammation, and multiorgan involvement....
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2025-05-01
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| author | Diana-Andreea Ciortea Mădălina Nicoleta Matei Mihaela Debita Ancuța Lupu Mirela Mătăsaru Gabriela Isabela Verga (Răuță) Silvia Fotea |
| author_facet | Diana-Andreea Ciortea Mădălina Nicoleta Matei Mihaela Debita Ancuța Lupu Mirela Mătăsaru Gabriela Isabela Verga (Răuță) Silvia Fotea |
| author_sort | Diana-Andreea Ciortea |
| collection | DOAJ |
| description | Background: Cardiac involvement is a key prognostic factor in multisystem inflammatory syndrome in children (MIS-C), a rare but serious inflammatory condition that typically occurs 2–6 weeks after SARS-CoV-2 infection and is characterized by fever, systemic inflammation, and multiorgan involvement. Biomarkers may aid in early detection, severity assessment, and treatment stratification. Objective: To evaluate the diagnostic utility of established and emerging serum biomarkers in MIS-C, with an emphasis on cardiac dysfunction and disease severity. Methods: A systematic search was conducted in PubMed, Scopus, and Web of Science up to April 2025. Eligible studies included pediatric MIS-C cases with reported serum biomarkers. Meta-analyses were performed for NT-proBNP and troponin using random-effects models. Descriptive profiling was applied to emerging biomarkers. Subgroup comparisons were explored between severe and moderate MIS-C. Quality assessment followed the Newcastle–Ottawa Scale, and publication bias was assessed via funnel plots and Egger’s test. Results: A total of 67 studies were included, comprising >4000 pediatric MIS-C cases. NT-proBNP and troponin were consistently elevated (pooled means: 9697 pg/mL and 0.384 ng/mL, respectively), with a low risk of publication bias. Emerging biomarkers such as CXCL9, angiopoietin-2, and vitamin D revealed high inter-study variability but potential prognostic value. Subgroup analyses for selected studies (n = 5) suggested higher biomarker levels in severe MIS-C. Conclusions: NT-proBNP and troponin are robust indicators of cardiac injury in MIS-C. Emerging biomarkers show promise but require validation. Future studies should include copeptin and adopt standardized reporting to refine biomarker-guided management. |
| format | Article |
| id | doaj-art-e54e38bec3d0484bb8595c6c44e9e3cd |
| institution | OA Journals |
| issn | 2075-1729 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | MDPI AG |
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| series | Life |
| spelling | doaj-art-e54e38bec3d0484bb8595c6c44e9e3cd2025-08-20T01:56:31ZengMDPI AGLife2075-17292025-05-0115580510.3390/life15050805Cardiac Manifestations and Emerging Biomarkers in Multisystem Inflammatory Syndrome in Children (MIS-C): A Systematic Review and Meta-AnalysisDiana-Andreea Ciortea0Mădălina Nicoleta Matei1Mihaela Debita2Ancuța Lupu3Mirela Mătăsaru4Gabriela Isabela Verga (Răuță)5Silvia Fotea6Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, RomaniaFaculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, RomaniaFaculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, RomaniaDepartment of Mother and Child Medicine, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaFaculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, RomaniaFaculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, RomaniaFaculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, RomaniaBackground: Cardiac involvement is a key prognostic factor in multisystem inflammatory syndrome in children (MIS-C), a rare but serious inflammatory condition that typically occurs 2–6 weeks after SARS-CoV-2 infection and is characterized by fever, systemic inflammation, and multiorgan involvement. Biomarkers may aid in early detection, severity assessment, and treatment stratification. Objective: To evaluate the diagnostic utility of established and emerging serum biomarkers in MIS-C, with an emphasis on cardiac dysfunction and disease severity. Methods: A systematic search was conducted in PubMed, Scopus, and Web of Science up to April 2025. Eligible studies included pediatric MIS-C cases with reported serum biomarkers. Meta-analyses were performed for NT-proBNP and troponin using random-effects models. Descriptive profiling was applied to emerging biomarkers. Subgroup comparisons were explored between severe and moderate MIS-C. Quality assessment followed the Newcastle–Ottawa Scale, and publication bias was assessed via funnel plots and Egger’s test. Results: A total of 67 studies were included, comprising >4000 pediatric MIS-C cases. NT-proBNP and troponin were consistently elevated (pooled means: 9697 pg/mL and 0.384 ng/mL, respectively), with a low risk of publication bias. Emerging biomarkers such as CXCL9, angiopoietin-2, and vitamin D revealed high inter-study variability but potential prognostic value. Subgroup analyses for selected studies (n = 5) suggested higher biomarker levels in severe MIS-C. Conclusions: NT-proBNP and troponin are robust indicators of cardiac injury in MIS-C. Emerging biomarkers show promise but require validation. Future studies should include copeptin and adopt standardized reporting to refine biomarker-guided management.https://www.mdpi.com/2075-1729/15/5/805multisystem inflammatory syndrome in children (MIS-C)biomarkersNT-proBNPtroponincopeptin |
| spellingShingle | Diana-Andreea Ciortea Mădălina Nicoleta Matei Mihaela Debita Ancuța Lupu Mirela Mătăsaru Gabriela Isabela Verga (Răuță) Silvia Fotea Cardiac Manifestations and Emerging Biomarkers in Multisystem Inflammatory Syndrome in Children (MIS-C): A Systematic Review and Meta-Analysis Life multisystem inflammatory syndrome in children (MIS-C) biomarkers NT-proBNP troponin copeptin |
| title | Cardiac Manifestations and Emerging Biomarkers in Multisystem Inflammatory Syndrome in Children (MIS-C): A Systematic Review and Meta-Analysis |
| title_full | Cardiac Manifestations and Emerging Biomarkers in Multisystem Inflammatory Syndrome in Children (MIS-C): A Systematic Review and Meta-Analysis |
| title_fullStr | Cardiac Manifestations and Emerging Biomarkers in Multisystem Inflammatory Syndrome in Children (MIS-C): A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Cardiac Manifestations and Emerging Biomarkers in Multisystem Inflammatory Syndrome in Children (MIS-C): A Systematic Review and Meta-Analysis |
| title_short | Cardiac Manifestations and Emerging Biomarkers in Multisystem Inflammatory Syndrome in Children (MIS-C): A Systematic Review and Meta-Analysis |
| title_sort | cardiac manifestations and emerging biomarkers in multisystem inflammatory syndrome in children mis c a systematic review and meta analysis |
| topic | multisystem inflammatory syndrome in children (MIS-C) biomarkers NT-proBNP troponin copeptin |
| url | https://www.mdpi.com/2075-1729/15/5/805 |
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