Evidence map›Paper›PMID 41099225›Full record

Observational studyPediatrics international : official journal of the Japan Pediatric Society

Vitamin D may influence disease course in PIMS-TS/MIS-C: An observational cohort study.

James E G Charlesworth, Joshua Navarajasegaran, Akhila Kavirayani, Avishay Sarfatti, Satish Adwani, Stéphane Paulus, Shelley Segal, James J Gilchrist, Dominic F Kelly, Emily A Lees

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Pediatrics international : official journal of the Japan Pediatric Society. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Vitamin D may influence disease course in PIMS-TS/MIS-C: An observational cohort study.Pediatrics international : official journal of the Japan Pediatric Society
    Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

James E G CharlesworthDepartment of Paediatrics, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK.ORCID https://orcid.org/0000-0001-9859-7383
Joshua NavarajasegaranAcute General Medicine, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK.ORCID https://orcid.org/0000-0003-3717-1295
Akhila KavirayaniPaediatric Rheumatology, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK.ORCID https://orcid.org/0000-0002-7447-5514
Avishay SarfattiPaediatric Intensive Care Unit, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK.ORCID https://orcid.org/0009-0003-3767-5343
Satish AdwaniPaediatric Cardiology, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK.ORCID https://orcid.org/0000-0002-4693-5309
Stéphane PaulusDepartment of Paediatrics, University of Oxford, John Radcliffe Hospital, Oxford, UK.ORCID https://orcid.org/0000-0002-0703-9114
Shelley SegalDepartment of Paediatrics, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK.ORCID https://orcid.org/0000-0002-0697-1719
James J GilchristDepartment of Paediatrics, University of Oxford, John Radcliffe Hospital, Oxford, UK.ORCID https://orcid.org/0000-0003-2045-6788
Dominic F KellyDepartment of Paediatrics, University of Oxford, John Radcliffe Hospital, Oxford, UK.ORCID https://orcid.org/0000-0002-6063-8896
Emily A LeesDepartment of Paediatrics, University of Oxford, John Radcliffe Hospital, Oxford, UK.ORCID https://orcid.org/0000-0003-0229-7509

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPediatric multisystem inflammatory syndrome temporally associated with SARS-CoV-2 (PIMS-TS) remains an enigmatic disease process, with phenotypic similarities to Kawasaki disease, although many patients present with transient cardiac dysfunction. Biomarkers help validate diagnosis, but the correlation of biomarkers to disease severity or prognosis is poorly understood.

designWe retrospectively reviewed PIMS-TS patients treated in Oxford between May 2020 and May 2022. Data on demographics, presenting features, biochemical markers, treatment, and outcomes were reviewed, and patients with/without the need for vasoactive medications were compared.

resultsWe identified 63 patients, median age 10.3 years (range 1.2-15.2 years). Where tested, 51/54 (94.4%) were SARS-CoV-2-antibody positive. Admissions followed regional peaks in SARS-CoV-2 infection. Forty children (63.5%) required vasoactive medications. Amongst those requiring vasoactive medications, peak NT-pro-BNP (median 11,363 ng/L vs. 3741 ng/L, p = 0.004) and length of stay (median 8.4 vs. 6.4 days, p = 0.021) were greater. Vitamin D levels inversely correlated with peak CRP (spearman r = -0.34, p = 0.007) and duration of vasoactive medications (spearman r = -0.34, p = 0.030). Furthermore, low serum vitamin D correlated with lower SARS-CoV-2 anti-nucleocapsid titers (spearman r = 0.43, p = 0.0014). Children receiving IV methylprednisolone, 54/63 (85.7%) (of whom, 16/54 received IVIg and methylprednisolone) had a more rapid fall in CRP than those given IVIg alone (7/63; 11.1%) or no immunomodulatory treatment (2/63; 3.2%). No patients had coronary artery aneurysm or persistent cardiac sequelae at discharge.

conclusionsMethylprednisolone suppressed CRP early and without evidence of coronary aneurysm in this cohort. We demonstrate a relationship between vitamin D, SARS-CoV-2 anti-nucleocapsid antibody production, inflammatory biomarkers, and duration of vasoactive medication, requiring further validation.

Indexed as

COVID-19Systemic Inflammatory Response SyndromeVitamin DAdolescentBiomarkersChildChild, PreschoolCohort StudiesCOVID-19 Drug TreatmentFemaleHumansInfantMalePrognosisRetrospective StudiesSeverity of Illness IndexBiomarkersVitamin DCOVID‐19MIS‐Cpediatric infectious diseasePIMS‐TSSARS‐CoV‐2

Identifiers

PMID41099225
PMCPMC12529462

What OpenQuestion holds

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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.