LEVEL OF TRANSFORMING GROWTH FACTOR-Β1 IN CHILDREN WITH CORONAVIRUS DISEASE AND MULTISYSTEM INFLAMMATORY SYNDROME: IMPACT ON DISEASE SEVERITY AND DIAGNOSTIC VALUE

Abstract

Introduction. Among the predictors of coronavirus disease severity, transforming growth factor beta-1 (TGF-β1) is distinguished. It participates in processes of cell proliferation, differentiation, migration, and apoptosis, and is considered a marker of profibrotic changes, particularly in the lungs, as well as a participant in the proinflammatory cascade. The Aim of the Study – to determine the TGF-β1 levels in groups of children with coronavirus disease (COVID-19) and multisystem inflammatory syndrome (MIS-C), to identify age- and sex-related differences in TGF-β1 levels during SARS-CoV-2 infection, and to assess the combined effect of TGF-β1, age, and sex on the risk of severe COVID-19 and MIS-C in children. Research Methods. A total of 200 children with COVID-19 and 40 children with MIS-C were examined. All children underwent laboratory measurement of TGF-β1 levels using an ELISA method with the TGF-β1 (Transforming Growth Factor Beta 1) ELISA Kit (E-EL-0162). Statistical analysis was performed using GraphPad Prism 8.4.3 and Statistica 13.0. Statistical significance was set at p < 0.05. Results and Discussion. Children with MIS-C had significantly higher TGF-β1 levels (2.32 (2.02; 3.02) ng/mL) compared with patients with mild COVID-19 (1.79 (1.38; 2.07) ng/mL) (p < 0.05). Boys with COVID-19 had significantly lower TGF-β1 levels compared with boys with MIS-C (p < 0.05). Logistic regression analysis showed that severe COVID-19 was not associated with changes in TGF-β1 concentration (p = 0.759) and depended only on patient age (p = 0.014). In contrast, the development of MIS-C was associated with elevated TGF-β1 levels (OR 3.58; 95 % CI 1.49–8.62; p = 0.005). Conclusions. Elevated TGF-β1 levels are characteristic of children with MIS-C and may be considered a potential biomarker of the risk of developing this condition, which should be taken into account in the diagnostic algorithm and management of this SARS-CoV-2-associated condition in pediatric practice.