Challenges of Diagnosing Viral Myocarditis in Adolescents in the Era of COVID-19 and MIS-C

Table 1

Laboratory values from the time of presentation and at the time of discharge.

	Initial presentation	At discharge
Troponin T	1.11 ng/mL (normal reference <0.01)	0.10 ng/mL
N-terminal pro-B-type natriuretic peptide (NT-proBNP)	2,312 pg/mL (<125)	796 pg/mL
D-dimer	2.29 mg/L FEU (<0.50)	0.73 mg/L FEU
Fibrinogen	851 mg/dL (194–448)
CRP	201.3 mg/L^a	8.2 mg/L
ESR	68 mm/hr (0–20)	12 mm/hr^b
Ferritin	121 ng/mL (30–400)	51 ng/mL
Angiotensin-converting enzyme	31 U/L (8–52)	20 U/L
Interleukin-6	65.2 pg/mL (<5)	-

^aCRP <1.0 indicates lower relative cardiovascular (CV) risk, 1.0–3.0 = average relative CV risk, 3.0–10.0 = higher relative CV risk, and >10.0 may be associated with infection and inflammation. ^bESR value is from follow-up appointment, which was 3 days after discharge.