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Reisner A, Blackwell LS, Sayeed I, Myers HE, Wali B, Heilman S, Figueroa J, Lu A, Hussaini L, Anderson EJ, Shane AL, Rostad CA. Osteopontin as a biomarker for COVID-19 severity and multisystem inflammatory syndrome in children: A pilot study. Exp Biol Med (Maywood) 2021; 247:145-151. [PMID: 34565198 DOI: 10.1177/15353702211046835] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
This study sought to evaluate the candidacy of plasma osteopontin (OPN) as a biomarker of COVID-19 severity and multisystem inflammatory condition in children (MIS-C) in children. A retrospective analysis of 26 children (0-21 years of age) admitted to Children's Healthcare of Atlanta with a diagnosis of COVID-19 between March 17 and May 26, 2020 was undertaken. The patients were classified into three categories based on COVID-19 severity levels: asymptomatic or minimally symptomatic (control population, admitted for other non-COVID-19 conditions), mild/moderate, and severe COVID-19. A fourth category of children met the Centers for Disease Control and Prevention's case definition for MIS-C. Residual blood samples were analyzed for OPN, a marker of inflammation using commercial ELISA kits (R&D), and results were correlated with clinical data. This study demonstrates that OPN levels are significantly elevated in children hospitalized with moderate and severe COVID-19 and MIS-C compared to OPN levels in mild/asymptomatic children. Further, OPN differentiated among clinical levels of severity in COVID-19, while other inflammatory markers including maximum erythrocyte sedimentation rate, C-reactive protein and ferritin, minimum lymphocyte and platelet counts, soluble interleukin-2R, and interleukin-6 did not. We conclude OPN is a potential biomarker of COVID-19 severity and MIS-C in children that may have future clinical utility. The specificity and positive predictive value of this marker for COVID-19 and MIS-C are areas for future larger prospective research studies.
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Affiliation(s)
- Andrew Reisner
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA.,Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA 30322, USA.,Department of Neurosurgery, Children's Healthcare of Atlanta, Atlanta, GA 30342, USA
| | - Laura S Blackwell
- Department of Neurosurgery, Children's Healthcare of Atlanta, Atlanta, GA 30342, USA
| | - Iqbal Sayeed
- Department of Emergency Medicine, Brain Research Laboratory, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Hannah E Myers
- Department of Neurosurgery, Children's Healthcare of Atlanta, Atlanta, GA 30342, USA
| | - Bushra Wali
- Department of Emergency Medicine, Brain Research Laboratory, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Stacy Heilman
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Janet Figueroa
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Austin Lu
- Division of Infectious Disease, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA.,Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, Atlanta, GA 30342, USA
| | - Laila Hussaini
- Division of Infectious Disease, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA.,Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, Atlanta, GA 30342, USA
| | - Evan J Anderson
- Division of Infectious Disease, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA.,Department of Medicine, 12239Emory University School of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA.,Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, Atlanta, GA 30342, USA
| | - Andi L Shane
- Division of Infectious Disease, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA.,Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, Atlanta, GA 30342, USA
| | - Christina A Rostad
- Division of Infectious Disease, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA.,Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, Atlanta, GA 30342, USA
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Blackwell LS, Martinez M, Fournier-Goodnight A, Figueroa J, Appert A, Vats A, Wali B, Sayeed I, Reisner A. Patterns of Osteopontin Expression in Abusive Head Trauma Compared with Other Causes of Pediatric Traumatic Brain Injury. J Pediatr 2020; 227:170-175. [PMID: 32622673 PMCID: PMC7686267 DOI: 10.1016/j.jpeds.2020.06.080] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/24/2020] [Accepted: 06/25/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To examine levels of plasma osteopontin (OPN), a recently described neuroinflammatory biomarker, in children with abusive head trauma (AHT) compared with children with other types of traumatic brain injury (TBI). STUDY DESIGN The study cohort comprised children aged <4 years diagnosed with TBI and seen in the intensive care unit in a tertiary children's hospital. Patients were classified as having confirmed or suspected AHT or TBI by other mechanisms (eg, motor vehicle accidents), as identified by a Child Protection Team clinician. Serial blood samples were collected at admission and at 24, 48, and 72 hours after admission. Levels of OPN were compared across groups. RESULTS Of 77 patients identified, 24 had confirmed AHT, 12 had suspected AHT, and 41 had TBI. There were no differences in the Glasgow Coma Scale score between the patients with confirmed AHT and those with suspected AHT and those with TBI (median score, 4.5 vs 4 and 7; P = .39). At admission to the emergency department, OPN levels were significantly higher in children with confirmed AHT compared with the other 2 groups (mean confirmed AHT, 471.5 ng/mL; median suspected AHT, 322.3 ng/mL; mean TBI, 278.0 ng/mL; P = .03). Furthermore, the adjusted mean trajectory levels of OPN were significantly higher in the confirmed AHT group compared with the other 2 groups across all subsequent time points (P = <.01). CONCLUSIONS OPN is significantly elevated in children with confirmed AHT compared with those with suspected AHT and those with other types of TBI. OPN expression may help identify children with suspected AHT to aid resource stratification and triage of appropriate interventions for children who are potential victims of abuse.
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Affiliation(s)
- Laura S. Blackwell
- Department of Neuropsychology, Children’s Healthcare of Atlanta, Atlanta, GA
| | | | | | | | - Andrew Appert
- Department of Neuropsychology, Children’s Healthcare of Atlanta, Atlanta, GA
| | - Atul Vats
- Department of Neuropsychology, Children’s Healthcare of Atlanta, Atlanta, GA,Emory University, Atlanta, GA
| | | | | | - Andrew Reisner
- Department of Neuropsychology, Children’s Healthcare of Atlanta, Atlanta, GA
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