ASSOCIATION OF INTERCELLULAR ADHESION MOLECULE-1 LEVELS WITH CARDIOVASCULAR SYSTEM INVOLVEMENT IN CHILDREN INFECTED WITH SARS-COV-2
DOI:
https://doi.org/10.11603/24116-4944.2026.1.16385Keywords:
ІСАМ-1, COVID-19, MIS-C, childrenAbstract
The aim of this study − to investigate the association between intercellular adhesion molecule-1 (ICAM-1) levels and cardiovascular system involvement, as well as to assess the prognostic role of ICAM-1 in the development of cardiac injury in children with COVID-19 and MIS-C.
Materials and Methods. The study included 240 children aged from 1 month to 17 years, of whom 200 were diagnosed with acute COVID-19 infection and 40 with MIS-C. Serum ICAM-1 levels were determined using enzyme-linked immunosorbent assay (ELISA) with the Human ICAM-1/CD54 test kit (Elabscience, USA). Cardiovascular system involvement was established based on clinical and/or instrumental findings, including myocarditis, pericarditis, coronary aneurysms or coronary artery dilatation, as well as the development of hypotension or shock.
Results and Discussion. ICAM-1 levels in children with cardiac involvement were significantly higher compared to patients without signs of cardiovascular system injury and amounted to 4.04 (2.39; 4.86) ng/mL versus 2.50 (2.00; 3.00) ng/mL, respectively (p=0.004). Correlation analysis revealed a statistically significant positive association between ICAM-1 levels and troponin I concentrations (rs=0.29; p=0.034). According to the univariate logistic regression analysis, elevated ICAM-1 levels were associated with an increased risk of cardiac involvement in children with COVID-19 and MIS-C (OR=2.028; 95 % CI 1.138–3.617; p=0.017). In the multivariate model adjusted for age and sex, the association between ICAM-1 levels and the risk of cardiovascular involvement remained statistically significant (OR=2.047; 95 % CI 1.133–3.697; p=0.018).
Conclusions. Endothelial dysfunction developing in COVID-19 and MIS-C is associated with cardiovascular system involvement. This is confirmed by significantly elevated ICAM-1 levels in patients with cardiac injury, the presence of a positive correlation with troponin I, and the independent prognostic significance of ICAM-1 regarding the risk of cardiovascular involvement in children. ICAM-1 may be considered a promising biomarker for the early detection of cardiac injury in children with SARS-CoV-2-associated conditions.
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