Impaired Glucose-Insulin Metabolism in Multisystem Inflammatory Syndrome Related to SARS-CoV-2 in Children

• Main Authors: Valeria Calcaterra (Author), Pietro Bosoni (Author), Dario Dilillo (Author), Savina Mannarino (Author), Laura Fiori (Author), Valentina Fabiano (Author), Patrizia Carlucci (Author), Elisabetta Di Profio (Author), Elvira Verduci (Author), Chiara Mameli (Author), Gloria Pelizzo (Author), Elena Zoia (Author), Lucia Sacchi (Author), Cristiana Larizza (Author), Gianvincenzo Zuccotti (Author)
• Format: Book
• Published: MDPI AG, 2021-05-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.3390/children8050384; 2227-9067
• Keywords: multisystem inflammatory syndrome; SARS-CoV-2; glucose; insulin; children; Pediatrics; RJ1-570
• Source: Children, Vol 8, Iss 5, p 384 (2021)

An interaction between metabolic glucose impairment and coronavirus disease 2019 is reported. The development of a severe multisystem inflammatory syndrome in children (MIS-C) related to SARS-CoV-2 infection has been described. We evaluated the impact of MIS-C on glycemic patterns in pediatric patients. A group of 30 children and adolescents affected by MIS-C were considered; all patients were normal weight. Clinical and biochemical assessments, including surrogate markers of insulin resistance (IR) such as homeostasis model analysis-IR (HOMA-IR) and triglyceride-glucose (TyG) indexes, were recorded. Patients were also invited to undergo an intermittently scanned continuous glucose monitoring (isCGM). HOMA-IR index was calculated in 18 patients (60%), of which 17 (94%) revealed a pathological value. TyG index was computed for all patients and pathological values were detected in all cases. In 15 patients, isCGM data were recorded on average for 9 days (±3 days). Overall, average glucose was 105 mg/dL (±16 mg/dL) and average time spent in the 70-180 mg/dL range (TIR) was 93.76%, with nearly 10% of glucose readings in the 141-180 mg/dL range; glycemic fluctuations over the hyperglycemic threshold were detected in four patients. Regular glucose monitoring may be useful to prevent metabolic imbalance and obtain a better outcome.