Evidence map›Paper›PMID 35725405›Full record

ArticleBMC infectious diseases2022

Monocyte anisocytosis increases during multisystem inflammatory syndrome in children with cardiovascular complications.

Lael M Yonker, Oluwakemi Badaki-Makun, Puneeta Arya, Brittany P Boribong, Gabriela Moraru, Brittany Fenner, Jaimar Rincon, Alex Hopke, Brent Rogers, Jeremiah Hinson and 8 more

Erratum issuedOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC infectious diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
2.2field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
  2. Article
  3. Resolvin D2 restores monocyte anisocytosis and mediates a shift toward classical monocytes ex vivo in blood samples from patients after major burns.FASEB journal : official publication of the Federation of American Societies for Experimental Biology · 2025
    Article
  4. Monocyte Anisocytosis Changes in Patients After Major Burn Injuries.Journal of burn care & research : official publication of the American Burn Association · 2025
    Article
  5. Review
  6. Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors at 8 institutions in 1 country.

Lael M YonkerDepartment of Pediatrics, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA. lyonker@mgh.harvard.edu.
Oluwakemi Badaki-MakunDepartment of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Puneeta AryaDepartment of Pediatrics, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
Brittany P BoribongDepartment of Pediatrics, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
Gabriela MoraruJackson Memorial Hospital, Miami, FL, USA.
Brittany FennerDepartment of Surgery, University of Florida, Gainesville, FL, USA.
Jaimar RinconDepartment of Surgery, University of Florida, Gainesville, FL, USA.
Alex HopkeHarvard Medical School, Boston, MA, USA.
Brent RogersJackson Memorial Hospital, Miami, FL, USA.
Jeremiah HinsonDepartment of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Alessio FasanoDepartment of Pediatrics, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
Lilly LeeJackson Memorial Hospital, Miami, FL, USA.
Sarah M KehoeDanaher Diagnostics LLC, Boston, MA, USA.
Shawn D LarsonDepartment of Surgery, University of Florida, Gainesville, FL, USA.
Hector ChavezJackson Memorial Hospital, Miami, FL, USA.
Scott LevinDepartment of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Lyle L MoldawerDepartment of Surgery, University of Florida, Gainesville, FL, USA.
Daniel IrimiaHarvard Medical School, Boston, MA, USA. dirimia@mgh.harvard.edu.
Jackson Memorial Hospital · USUniversity of Florida · USHarvard University · USJohns Hopkins University · USMassachusetts General Hospital · USBurn Institute · USDanaher (United States) · USJohns Hopkins Medicine · US

Funding

Renewal: Dysfunctional Myelopoiesis and Myeloid-Derived Suppressor Cells in Sepsis PathobiologyRM1GM139690 · NIGMS · UNIVERSITY OF FLORIDA · PI Philip A Efron, Michael Paul Kladde · 2021 to 2026
$10.3M
Neutrophil Decision Making in Confined Environments in Health and DiseaseR01GM092804 · NIGMS · MASSACHUSETTS GENERAL HOSPITAL · PI IRIMIA, DANIEL · 2010 to 2022
$4.3M
Microfluidic Assessment of Clinical Outcomes in Preterm NewbornsR01HD089939 · NICHD · UNIVERSITY OF FLORIDA · PI IRIMIA, DANIEL, MOLDAWER, LYLE L · 2017 to 2021
$3.3M
Mechanistically Disentangling the Infected, Inflamed LungK08HL143183 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI YONKER, LAEL · 2018 to 2022
$869k
Biomedical Advanced Research and Development Authority 75A50120C00189Eunice Kennedy Shriver National Institute of Child Health and Human Development HD089939NHLBI NIH HHS 5K08HL143183NHLBI NIH HHS K08 HL143183NICHD NIH HHS R01 HD089939NIGMS NIH HHS GM092804NIGMS NIH HHS GM139690NIGMS NIH HHS R01 GM092804NIGMS NIH HHS RM1 GM139690
6 · The paper itself

Abstract

backgroundMultisystem inflammatory syndrome in children (MIS-C) is a life-threatening complication that can develop weeks to months after an initial SARS-CoV-2 infection. A complex, time-consuming laboratory evaluation is currently required to distinguish MIS-C from other illnesses. New assays are urgently needed early in the evaluation process to expedite MIS-C workup and initiate treatment when appropriate. This study aimed to measure the performance of a monocyte anisocytosis index, obtained on routine complete blood count (CBC), to rapidly identify subjects with MIS-C at risk for cardiac complications.

methodsWe measured monocyte anisocytosis, quantified by monocyte distribution width (MDW), in blood samples collected from children who sought medical care in a single medical center from April 2020 to October 2020 (discovery cohort). After identifying an effective MDW threshold associated with MIS-C, we tested the utility of MDW as a tier 1 assay for MIS-C at multiple institutions from October 2020 to October 2021 (validation cohort). The main outcome was the early screening of MIS-C, with a focus on children with MIS-C who displayed cardiac complications. The screening accuracy of MDW was compared to tier 1 routine laboratory tests recommended for evaluating a child for MIS-C.

resultsWe enrolled 765 children and collected 846 blood samples for analysis. In the discovery cohort, monocyte anisocytosis, quantified as an MDW threshold of 24.0, had 100% sensitivity (95% CI 78-100%) and 80% specificity (95% CI 69-88%) for identifying MIS-C. In the validation cohort, an initial MDW greater than 24.0 maintained a 100% sensitivity (95% CI 80-100%) and monocyte anisocytosis displayed a diagnostic accuracy greater that other clinically available hematologic parameters. Monocyte anisocytosis decreased with disease resolution to values equivalent to those of healthy controls.

conclusionsMonocyte anisocytosis detected by CBC early in the clinical workup improves the identification of children with MIS-C with cardiac complications, thereby creating opportunities for improving current practice guidelines.

Indexed as

COVID-19ChildHumansMonocytesSARS-CoV-2Systemic Inflammatory Response SyndromeMonocyte distribution widthMultisystem inflammatory syndrome in childrenPediatric COVID-19

Identifiers

PMID35725405
PMCPMC9208352
OpenAlexW4283156351

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.