Can Low-High-Density Lipoprotein Be a New Risk Factor for Multisystemic Inflammatory Syndrome in Children?

Abstract Objectives: Increasing acute phase reactants due to inflammation or infection cause some changes in lipid and lipoprotein metabolism. High-density lipoprotein(HDL) is part of the innate immune system that fights pathogens entering the body. Therefore, we think HDL has prognostic value in multisystemic inflammatory syndrome associated with Coronavirus (MIS-C) as in Kawasaki disease and other diseases. Study Design: We followed the 51 patients diagnosed with MİSS-C. We divided the patient into two groups according to cardiac involvement, and we compared the laboratory values of the patients. Results: Of these 51 patients, 65% (33) were male, and 35% (18) were female. We performed the echocardiographic examination on all patients, 69% (35) of the patients had cardiac pathology, and 31%(16) patients had no cardiac involvement. When comparing the patients' cholesterol levels according to cardiac involvement, the triglyceride value was higher in patients with the cardiac involvement group. The median triglyceride values of patients with cardiac participation were 192.6 mg/dl, and those without cardiac involvement were 134.2 mg/dl. (p=0.028) (IQR 119.4 – 122.9). And also, the HDL value was lower in patients with cardiac involvement. We found that the median HDL values of the patients with cardiac participation were 13.65mg/dl, and the median HDL values of the patients without cardiac involvement were 21.8mg/dl(p=0.003)(IQR 6 - 31) Conclusion: We found that not only high leukocyte and CRP values were associated with the severity of the disease, but also low HDL and high triglyceride values were associated with cardiac involvement.