The Value of NSE, S100, and E-Selectin Biomarkers for Predicting the Course and Severity of COVID-19 in Children

Abstract

Objective — to investigate the relationship between the level of NSE, S100 and E-selectin biomarkers with the complicated course and symptoms of the nervous system in children with COVID-19. Materials and methods. We conducted a pilot, cohort, observational, retrospective study involving 88 children aged 1 month to 18 years with laboratory-confirmed COVID-19 by the PCR method, who underwent inpatient treatment at the Kyiv City Children’s Clinical Infectious Disease Hospital in 2021—2022. During the first day of hospital stay, blood serum was collected from patients and the level of NSE, S100 and E-selectin biomarkers was determined by enzyme immunoassay. Results and discussion. A complicated course was observed in 42 (47.7 %) patients. Symptoms from the nervous system were noted in 46 (52 %) patients. In patients with an uncomplicated course, the average level of NSE on the first day of inpatient treatment was (12.1 ± 1.2) μg/l, S100 — (164 ± 8.2) ng/l, E-selectin (12.02 ± 1.7) ng/ml. In patients with a complicated course, the average levels of biomarkers were, respectively: (16.9 ± 1.5) μg/L, (165.9 ± 6.9) ng/L, and (15.04 ± 1.9) ng/mL. An increase in the level of NSE above 15 μg/L and E-selectin above 25 ng/ml was associated with a significant increase in the risk of clinical symptoms from the nervous system and a complicated course in children with COVID-19 (p < 0.05). The value of the S100 index above 150 ng/l was associated with an increased risk of clinical symptoms of nervous system damage (p < 0.05) and a tendency to complications (p < 0.1). The level of all biomarkers was also associated with an increase in the duration of inpatient treatment. Conclusions. Complicated course and onset of nervous system symptoms in children hospitalized with COVID-19 are associated with increased levels of the biomarkers NSE, S100, and E-selectin. Determina­tion of these biomarkers can be used in diagnostics to predict the course and severity of the disease in children undergoing inpatient treatment for COVID-19.