Unraveling The Role Of Inflammatory Markers In Multisystem Inflmmatroy Syndrome – A Comaparative Analysis In A Tertiary Care Hospital Of Southern Odisha

Abstract

Background: Multisystem inflammatory syndrome (MIS) is a rare and serious complication of COVID-19 that can affect different parts of the body. It can affect both children (MIS-C) and adults (MIS-A). MIS occurs in patients with pathophysiology characterised by hyperinflammation affecting multiorgan systems like gastrointestinal, renal, and cardiac involvement. The common presentation of fever, rash, headache, and sore throat are seen in acute covid patients. MIS in adults is complicated by the occurrence of hyperinflammation due to COVID 19 which presents with even broader spectrum of inflammatory markers which mimics other multisystem inflammatory disease like Kawasaki disease, toxic shock syndrome, macrophage activation syndrome. So, it is very important to diagnose the MIS and categorise whether the MIS is due to covid 19 or any other illness where the presentation is almost similar. Inflammatory markers play a major role is diagnosis and assessing the severity in MIS. In the present study, it was mainly aimed to estimate and compare the quantitative level of inflammatory markers in acute covid and MIS patients having positive and negative RTPCR for COVID 19. Hence the objective of a better diagnostic and predictive value can be elucidated by advising the healthcare facilities to go for assay of inflammatory markers along with observation of clinical manifestation and illness progression.

Methods: This retrospective observational study was carried out in Biochemical laboratory of MKCG Medical college and hospital in association with department of Medicine and Paediatrics from January to April 2023 which included 88 patients out of which 44 patients were diagnosed as acute covid (Group I),18 patients were MIS with RTPCR negative for covid virus (Group II) and 26 patients were MIS with positive RTPCR for covid virus (Group III).The serum sample for CRP(Q), Ferritin and D-Dimer were measured by immunoturbidimetry assay in MISPA i3 protein analyser. The serum sample was used for analysis of FBS, urea, creatinine, SGPT, SGOT and LDH by colorimetric method in automated analyser in TBA120FR.

Results: The level of serum urea, creatinine, SGPT, SGOT, LDH and inflammatory makers CRP(Q), Ferritin and coagulation marker D-Dimer were higher in MIS with RTPCR positive for covid (Group III) than the other two groups which was statistically significant (p<0.001)

Conclusion: Inflammatory markers and coagulation markers play a major role in recognising and treating the cases of MIS and in the present study it was very clear that the level of inflammatory and coagulation marker was significantly higher in MIS having COVID RTPCR positive as compared to MIS with COVID RTPCR negative but the levels were not elevated in acute covid.