Creatine Kinase as a Predictor of Disease Severity in Children with COVID-19.

Background: The majority of children with COVID-19 infection experience asymptomatic or mild disease, but some of them are at risk of developing severe illness. Determination of predictors of severe disease can help to prevent this form of disease in children. The aim of the current study was to determine the predictors of disease severity of COVID-19 infection based on laboratory markers and underlying conditions in children.

Methods: This cross-sectional study was conducted in Iran from May 2021 to March 2022. Thirty hundred and seventeen children under 18 years old with positive tests or pulmonary manifestations of COVID-19 referred to a teaching hospital in Tehran were included in the study. Demographic, laboratory, and clinical parameters of included children were measured. The participants were classified into three severity groups based on a severity-scoring protocol. Data was analyzed using SPSS software with chi-square, analysis of variance (ANOVA) tests, and linear generalized model. Statistical significance was considered at 0.05.

Results: Among 317 children, 186 patients (58.7%) were male. The mean age of the participants was 4.75 ± 4.47 years old. Examination of clinical factors showed cough (64%), Malaise (57.7%), and Tachypnea (35.3%) were the most frequent findings among the subjects. Employing the severity scoring protocol, most patients (69.1%) were classified into the mild group. There was a significant relationship between the severity of COVID-19 and the level of Hemoglobin, Aspartate Transaminase (AST), Alanine Transaminase (ALT), C-reactive protein (CRP), Lactate Dehydrogenase (LDH), Creatine Kinase (CK), D-dimer, Ferritin, and Fibrinogen (P<0.001). Creatine Kinase was found to be a predictor of COVID-19 severity in adjusted model. All underlying conditions, except asthma, were significantly associated with disease severity.

Conclusion: In our study, it was determined that CK could be considered a predictor of the severity of COVID-19 in children. These results suggest that integrating CK assessment into routine clinical protocols may aid healthcare providers in timely risk stratification and personalized patient care approaches.