Objective:

To evaluate the role of VEGF-D as a biomarker for disease severity in pediatric COVID-19 and MIS-C.

Approach:

• Study Design: Included 200 children with confirmed COVID-19, 40 children with MIS-C, and 24 healthy controls. Measured serum VEGF-D concentrations and various inflammatory markers.
• Analysis Methods: Used enzyme-linked immunosorbent assay (ELISA) for biomarker measurement and multivariable logistic regression for association analysis.

Key Findings:

• VEGF-D levels were significantly higher in children with COVID-19 (325.61 (189.93; 535.85) pg/ml) and MIS-C (920.92 (473.45; 1157.70) pg/ml) compared to controls (195.88 (115.58; 256.70) pg/ml).
• The highest VEGF-D levels were observed in patients with MIS-C and severe COVID-19.
• VEGF-D was independently associated with severe COVID-19 and MIS-C.
• Clinically relevant cut-off values for VEGF-D were established: 387.87 pg/mL for severe COVID-19 and 461.96 pg/mL for differentiating MIS-C from acute COVID-19.

Interpretation:

VEGF-D serves as an independent marker for assessing disease severity in pediatric COVID-19 and MIS-C.

Limitations:

• The study does not provide longitudinal data on VEGF-D levels over time.
• Sample size may limit the generalizability of findings.

Conclusion:

VEGF-D may assist in severity stratification and differentiating clinical phenotypes in pediatric COVID-19 and MIS-C.