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Fouda EM, Wahba NS, Elsharawy AIM, Ishak SR. Serum homocysteine level in pediatric patients with COVID-19 and its correlation with the disease severity. Pediatr Pulmonol 2022; 57:1701-1708. [PMID: 35420248 PMCID: PMC9088336 DOI: 10.1002/ppul.25920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/15/2022] [Accepted: 04/09/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Thrombosis and embolism are possible complications in coronavirus disease 2019 (COVID)-19-positive pediatric patients. Although the risk is lesser in children than it is in adults, it does exist during acute infection and multi-inflammatory syndrome in children. Biomarkers such asd-dimer, prothrombin time, and fibrinogen degradation products are ineffective at detecting disease severity. Homocysteine (Hcy) is a prothrombotic factor that has been reported to be higher in adult COVID-19 patients, leading to speculation that it could be used as a biomarker for disease severity. PURPOSE To detect the correlation between serum total homocysteine (tHcy) level and the severity of COVID-19 in pediatrics. METHODS A cross-sectional study was conducted on 40 children with COVID-19 and 40 healthy control subjects. Serum tHcy was measured by enzyme-linked immunosorbent assay and correlated with the clinical, laboratory, and radiological parameters of the patients. RESULTS The median serum tHcy level in COVID-19 patients was 27.5 (interquartile range [IQR]: 23-31.75) μmol/L, while that in the controls was 1.8 (IQR: 1.6-1.875) μmol/L. There was a statistically significant increase in the tHcy level in cases compared to controls (p < 0.001). There was a statistically significant positive correlation between serum tHcy and d-dimer, ferritin, alanine transaminase, aspartate transaminase, blood urea nitrogen, and a highly significant positive correlation between tHcy and COVID-19 reporting and data system score, pediatric intensive care unit admission, and the disease severity classification. CONCLUSION Hcy could be a biomarker of importance in predicting the severity of COVID-19 in pediatrics.
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Affiliation(s)
- Eman M Fouda
- Pediatrics Department, Ain Shams University, Cairo, Egypt
| | - Nancy S Wahba
- Clinical Pathology Department, Ain Shams University, Cairo, Egypt
| | | | - Sally R Ishak
- Pediatrics Department, Ain Shams University, Cairo, Egypt
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Treviño S, Cortezano-Esteban S, Hernández-Fragoso H, Díaz A, Vázquez-Roque R, Enrique Sarmiento-Ortega V, Moroni-González D, Pelayo R, Brambila E. Clinical monitored in subjects metabolically healthy and unhealthy before and during a SARS-CoV-2 infection– A cross-sectional study in Mexican population. Cytokine 2022; 153:155868. [PMID: 35358903 PMCID: PMC8958098 DOI: 10.1016/j.cyto.2022.155868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/02/2022] [Accepted: 03/21/2022] [Indexed: 12/14/2022]
Abstract
The COVID-19 disease has forced us to consider the physiologic role of obesity and metabolically healthy and unhealthy status in response to SARS-CoV-2 infection. Hematological, coagulation, biochemical, and immunoinflammatory changes have been informed with a disparity in morbidity and mortality. Therefore, we aimed to investigate the influence of metabolic health on clinical features in a cross-sectional study in Mexican subjects with and without SARS-CoV-2 infection in non-severe stages after a rigorous classification of obese and non-obese subjects who were metabolically healthy and unhealthy. Four groups were formed: 1) metabolically healthy with normal BMI (MHN); 2) metabolically unhealthy with normal BMI (MUN); 3) metabolically healthy obese (MHO); 4) metabolically unhealthy obese (MUO). Serum proinflammatory (TNF-α, MCP-1, IL-1β, and IL-6) and anti-inflammatory (TGF-β, IL-1Ra, IL-4, and IL-10) cytokines, hematological parameters, coagulation, and acute phase components were evaluated. Our results showed that MHO people live with inflammaging. Meanwhile, MUN and MUO subjects develop metaflammation. Both inflammaging and metaflammation cause imperceptible modifications on hematological parameters, mainly in leukocyte populations and platelets, as well as acute phase and coagulation components. The statistical analysis revealed that many clinical features are dependent on metabolic health. In conclusion, MHO subjects seem to be transitioning from metabolically healthy to unhealthy, which is accelerated in acute processes, such as SARS-CoV-2 infection. Meanwhile, metabolically unhealthy subjects independently of BMI have a deteriorating immunometabolic status associated with a hyperinflammatory state leading to multi-organ dysfunction, treatment complications, and severe COVID-19 disease.
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Affiliation(s)
- Samuel Treviño
- Laboratory of Chemical-Clinical Investigations, Department of Clinical Chemistry, Faculty of Chemistry Science, University Autonomous of Puebla. 14 South. FCQ1, University City, Puebla, C.P. 72560, Mexico; Clinical Laboratory "Los Ángeles, Endocrinology area, rio Nexapa 6153, col. San Manuel, Puebla, C.P. 72560, Mexico.
| | - Steffany Cortezano-Esteban
- Clinical Laboratory "Los Ángeles, Endocrinology area, rio Nexapa 6153, col. San Manuel, Puebla, C.P. 72560, Mexico
| | - Hugo Hernández-Fragoso
- Laboratory of Chemical-Clinical Investigations, Department of Clinical Chemistry, Faculty of Chemistry Science, University Autonomous of Puebla. 14 South. FCQ1, University City, Puebla, C.P. 72560, Mexico; Clinical Laboratory "Los Ángeles, Endocrinology area, rio Nexapa 6153, col. San Manuel, Puebla, C.P. 72560, Mexico
| | - Alfonso Díaz
- Department of Pharmacy, Faculty of Chemistry Science, University Autonomous of Puebla. 22 South. FCQ9, University City, Puebla, C.P. 72560, Mexico
| | - Rubén Vázquez-Roque
- Neuropsychiatry laboratory, Physiology Institute, University Autonomous of Puebla. 14 South. University City, Puebla, C.P. 72560, Mexico
| | - Victor Enrique Sarmiento-Ortega
- Laboratory of Chemical-Clinical Investigations, Department of Clinical Chemistry, Faculty of Chemistry Science, University Autonomous of Puebla. 14 South. FCQ1, University City, Puebla, C.P. 72560, Mexico
| | - Diana Moroni-González
- Laboratory of Chemical-Clinical Investigations, Department of Clinical Chemistry, Faculty of Chemistry Science, University Autonomous of Puebla. 14 South. FCQ1, University City, Puebla, C.P. 72560, Mexico
| | - Rosana Pelayo
- Eastern Biomedical Research Center CIBIOR, Mexican Institute for Social Security, Puebla, Mexico
| | - Eduardo Brambila
- Laboratory of Chemical-Clinical Investigations, Department of Clinical Chemistry, Faculty of Chemistry Science, University Autonomous of Puebla. 14 South. FCQ1, University City, Puebla, C.P. 72560, Mexico
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