Journal Article

Development of a Predictive Model for Cardiac Dysfunction in MIS-C Patients Utilizing Laboratory Biomarkers

Lee, Simon, Kaplan, Ron L., Abraham, Roshini S., Stephans, Allayne, Erdem, Guliz, Merryman, Brent, Yasuhara, Jun, Money, Nathan M., Galdo, Brendan, Aldag, Erin, Colgan, Jennifer, Rust, Steve, Bochner, Risa, Graf, Thomas, Vidal, Diego Cruz

2026

Overview

Background and Objectives: Early identification of cardiac dysfunction in multi-system inflammatory syndrome in children (MIS-C) is crucial for effective management. Our primary objective was to predict left ventricular systolic dysfunction (LVSD) through a multicenter collaborative assessing admission laboratory data and echocardiogram findings. Methods: Laboratory and clinical data were collected by retrospective chart review from a cohort of pediatric patients admitted and treated for MIS-C in our institutions. Laboratory data including absolute lymphocyte count, albumin, sedimentation rate, C-reactive protein, procalcitonin, d-dimer, fibrinogen, ferritin, interleukin-6 level, and lymphocyte subsets (T, B and NK quantitation, TBNK) were collected. We built a LASSO logistic regression model to predict which MIS-C patients would have left ventricular systolic dysfunction LVSD using only laboratory data obtained within the first 24 h of admission. Results: Of the 1474 MIS-C patients evaluated, 297 had LVSD. The linear kinetic analysis found differences in albumin, lymphocyte count, C-reactive proteins and fibrinogen for systolic dysfunction patients, and of these C-reactive proteins, fibrinogen and procalcitonin were more predictive earlier. The best model for coronary artery abnormalities (CAAs) performed poorly, with a mean cross-validated AUC of 0.57. The model performed well with a cross-validated AUC of 0.845. Conclusions: This model identified widely available biomarkers to successfully predict systolic dysfunction in MIS-C patients. Those at high risk of systolic dysfunction had higher peak laboratory values for C-reactive protein, fibrinogen, and procalcitonin early on. A regularized logistic regression model was validated to provide excellent discrimination for LVSD.

• Publisher: MDPI AG,Multidisciplinary Digital Publishing Institute (MDPI)
• Subject: Albumin / Algorithms / Biological markers / Biomarkers / C-reactive protein / Children / COVID-19 / Cytokines / data analytics / Disease transmission / Ferritin / Fibrin / Health aspects / Hispanic Americans / Infections / Interleukins / Kawasaki disease / Laboratories / left ventricular systolic dysfunction / Machine learning / Medical research / Medicine, Experimental / MIS-C / Multisystem inflammatory syndrome in children / Regression analysis / Severe acute respiratory syndrome coronavirus 2 / Ultrasonic imaging / Variables