الفهرس 
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Abstract
The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has emerged as a significant global public health disaster, with over 97 million reported illnesses and 2 million fatalities worldwide. This ongoing pandemic is considered one of the most serious health crises of the past century.
Covid-19 pediatric patients can be categorized into four distinct groups based on the varying degrees of symptom severity.
The objective of this study was to assess the association between IL-6 polymorphism and the severity of COVID-19 in pediatric patients admitted to our hospital between March 2021 and June 2021. The findings of this investigation contribute to the existing literature by providing insights into the prognostic evaluation of COVID-19.
The present investigation involved a sample size of 150 patients who met both the inclusion and exclusion criteria. All of these patients were children who were believed to have COVID-19 based on chest CT scan results, which were then confirmed by a positive PCR nasal swab for SARS-CoV-2.
Consents were obtained from the parents of all patients, both verbally and in written form. The research was conducted with the endorsement of the Ethical Committee of Minia College of Medicine, in accordance with the principles outlined in the Helsinki Declaration and its subsequent revisions. The ethical approval number for this study is 35: 2021.
The patients in our study were categorized into four distinct categories based on the severity of their condition: mild (n=67), moderate (n=52), severe (n=17), and critical (n=14).
All individuals in our study had a comprehensive assessment of their clinical history. A thorough medical history was obtained, encompassing anthropometric measurements such as weight, height, and body mass index, as well as assessments of blood pressure, pulse, temperature, respiratory rate, and inspections of the chest, heart, and abdomen.
Laboratory investigations were conducted on all patient groups, encompassing various tests such as Complete Blood Count (CBC), ferritin level assessment, serum D-dimer analysis, metabolic panel evaluation (including measurements of sodium, potassium, liver and kidney functions), C-reactive protein (CRP) quantification, serum interleukin 6 determination, complement 3 and complement 4 (C3 and C4) measurements, CXCL 10 assessment, serum Presepsin analysis, and examination of single-nucleotide polymorphisms (SNPs) of IL-6 (174 G / C), (572 G / C), and (597 G / A).
The findings of our study indicate that the levels of Presepsin and CXCL 10 in the blood were considerably elevated in both the severe and critical groups compared to the mild and moderate groups.
. The findings of our study indicate that levels of complement 3 and 4 were significantly reduced in both the severe and critical groups compared to the mild and moderate groups.
A notable distinction was observed among the four groups in relation to the interleukin-6 polymorphisms, specifically IL-6 174 and IL-6 572. However, no significant statistical distinction was observed among the four groups in relation to interleukin-6 polymorphisms (IL-6 597).
The levels of Presepsin, IL-6, and CXCL 10 exhibited a positive correlation with ferritin, D-dimer, mortality rates, chest computed tomography (CT) results, and the requirement for mechanical ventilation (MV).
There was a notable disparity observed in the IL-6 572 allelic distribution among individuals with severe symptoms, with the most prevalent genotype (GC) accounting for 47.1% of the cases. The odds ratio for this genotype was calculated to be 5.1. Therefore, the existence of the GC genotype of IL-6 572 is regarded as a risk factor for the severity of COVID-19 in patients.
There is a notable disparity observed in the distribution of the IL-6 174 allelic variant among individuals with critical cases, with the genotype (CC) being the most prevalent at a frequency of 78.6%. This particular genotype exhibits an Odds Ratio of 11.69. Therefore, the existence of the GC genotype of IL-6 174 is regarded as a risk factor in individuals with severe cases of COVID-19.
Based on the findings of this investigation, we endorse the utilization of IL-6 polymorphism in Covid-19 as a prognostic indicator for the severity of the disease in pediatric patients affected by Covid-19.
The selection of an appropriate pharmaceutical intervention to combat Covid infection is crucial for pediatricians to initiate effective treatment.
Additionally, it was observed that there was a notable increase in IL-6 polymorphism among patients in critical condition. This finding proves to be valuable in identifying death rates in conjunction with the severity of the illness.
Conclusion
from the results of our current study, we concluded that:
The present study aims to investigate the potential of CXCL10, Presepsin, and IL-6 polymorphism as predictors of severity in pediatric patients with COVID-19. The study focuses on the rapid computation of severity and its implications for prognosis evaluation in pediatric patients admitted to our hospital.
In the present investigation, it was observed that the blood levels of both Presepsin and CXCL 10 were found to be significantly elevated in the severe and critical groups as compared to the mild and moderate groups.
In the present investigation, a notable disparity was observed in the IL-6 572 allelic distribution among individuals with severe symptoms, with the most prevalent genotype (GC) accounting for 47.1% of the cases. Therefore, the existence of the GC genotype of IL-6 572 is regarded as a risk factor in individuals with severe cases of COVID-19.
In the present investigation, a notable disparity was observed in the IL-6 174 allelic distribution among individuals with critical cases, with the genotype (CC) being the most prevalent at a frequency of 78.6%. Therefore, the existence of the GC genotype of IL-6 174 is regarded as a risk factor in individuals with severe cases of COVID-19.
Based on our findings, it has been determined that IL6 polymorphism serves as an indicator of the severity of COVID-19 in pediatric patients. This information can be utilized to inform our treatment strategies, particularly in terms of selecting the most effective pharmaceutical intervention to eliminate the COVID-19 infection.
Recommendations
Based on the results of our study we recommend the following:
1. We propose the utilization of CXCL10, Presepsin, and IL-6 polymorphism as a novel prognostic indicator and risk stratification tool in pediatric patients with COVID-19. This recommendation is based on the advantages of their straightforward measurement, ease of detection, and convenient monitoring of patient outcomes.