Table 3.
Laboratory Finding of Multisystem Inflammatory Syndrome in Children (MIS-C). Clinical data extracted from Verdoni et al [47], Belhadjer et al [46], Whittaker et al [49], Cheung et al [50], Chiotos et al [48] and Waltuch et al [4] and grouped by country. For simplicity, Chiotos et al and Waltuch et al study information were combined. Verdoni et al lab findings are reported as mean (standard deviation), the rest are reported in median and interquartile ranges. *: NT-pro-BNP <300 is normal for adults (excluding the elderly); in children, the normal upper limit is much higher in infants (from newborn to 2 years of age) and progressively decreases in the first 6 years to adult range) [76]. **: The method of troponin testing was highly variable across case series. Belhadjer et al measured high-sensitivity troponin-I levels, whereas Cheung et al used high-sensitivity troponin-T levels. Verdoni et al reported troponin I levels, although the use of high-sensitivity lab technique was not specified. Whittaker et al, Cheung et al, Chiotos et al and Waltuch et al did not specify whether troponin-I or troponin-T was used, nor the use of high-sensitivity lab technique.
| Range | Italy | France and Switzerland | United Kingdom | United States | |
|---|---|---|---|---|---|
| Reference Source | Verdoni et al (Bergamo, Italy) | Belhadjer et al. (13 hospitals in Frances and 1 hospital in Switzerland) | Whittaker et al. (13 hospitals in the UK; includes the 8 patients from Riphagen et al.) | § - Cheung et al (Morgan Stanley Children's Hospital, New York); ¶ - Chiotos et al (CHOP, Philadelphia) and Waltuch et al (Mount Sinai, New York) | |
| Mean (SD) | Median (IQR) | Median (IQR) | Median (IQR) | ||
| WBC (x103/L) | <12 | 10.8 (6.1) | 16 (12 – 23) | 17 (12 – 22) | § - 14.0 (4 – 35.9) ¶ - 20.6 (11.1 – 35.7) |
| Absolute lymphocyte count | >950 | 860 (40) | N/A | 800 (500 – 1500) | § - 1212.1 (115.5 – 6444.9) ¶ - 310 (262 – 412) |
| Platelets (103/uL) | <150 | 130 (32) | N/A | 151 (104 – 210) | § - 237 (69 – 892) ¶ - 120 (96.5 – 166.25) |
| Peak BNP (pg/mL) | <100 | N/A | 4256 (2340 – 6503) | N/A | § - N/A ¶ - 1411 (517 – 3068) |
| Peak NT-pro BNP (pg/mL) | * | 1255 (929) | 41484 (35811 – 52475) | 788 (172 – 10548) | § - 15833 (631 – 59291) ¶ - N/A |
| Peak Troponin (ng/mL) | ** | 1.0 (1.862) | 0.408 (0.258 – 0.679) | 0.045 (0.008 – 0.294) | § - 0.0568 (0.006 – 0.278) ¶ - 0.24 (0.0675 – 0.8775) |
| CRP (mg/dL) | <0.9 | 25 (15.3) | 24.1 (15.0 – 31.1) | 22.9 (15.6 – 33.8) | § - 20.0 (1.7 – 30.0) ¶ - 26.7 (17.6 – 30.2) |
| D-Dimer (ug/mL) | <0.5 | 3.798 (1.318) | 5.284 (4.069 – 9.095) | 3.578 (2.085 – 8.235) | § - 4 (0.9 – 11) ¶ - 4.46 (3.3 – 11.5) |
| Pro-Calcitonin (ng/mL) | <2 | N/A | 36 (8 – 99) | N/A | § - 21.7 (0.8 – 127) ¶ - 16.0 (15.08 – 58.85) |
| IL-6 (pg/mL) | <8.5 | 117.1 (137.4) | 135 (87 – 175) | N/A | § - 226.3 (3.1 – 315) ¶ - 330 (268 – 406.5) |
| Ferritin (ng/mL) | <150 | 1176 (1032) | N/A | 610 (359 – 1280) | § - 647.9 (83 – 1828) ¶ - 973 (762 – 1188) |
CRP: C-reactive protein, IL: Interleukin, NT-proBNP: N-terminal pro hormone B-type natriuretic peptide, WBC: White blood cells.