Study Provides MIS-C Treatment Guidance In Children And Adol
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An analysis conducted by a group of investigators found that children and adolescents with Multisystem inflammatory syndrome in children (MIS-C) initially treated with intravenous immune globulin (IVIG) plus glucocorticoids had a lower risk of new or persistent cardiovascular dysfunction than IVIG alone.

The researchers analyzed surveillance data on 518 children and adolescents with MIS-C who were admitted to US hospitals between March 15 and October 31, 2020. Eighty-nine (17%) received IVIG only; 241 (47%) received IVIG and glucocorticoids; 107 (21%) received IVIG, glucocorticoids, and a biologic; and 81 (16%) received other treatments, including glucocorticoids only, a biologic only, glucocorticoids and a biologic, or IVIG and a biologic.

They found that initial treatment with IVIG plus glucocorticoids (103 patients) was associated with a lower risk of cardiovascular dysfunction on or after day two than IVIG alone -- 103 patients or 17% vs. 31%. Among those who received IVIG plus glucocorticoids, left ventricular dysfunction occurred in 8% and 17% of the patients, respectively, and shock resulting in vasopressor use in 13% and 24%. The use of adjunctive therapy was also lower among patients who received IVIG plus glucocorticoids than among those who received IVIG alone -- 34% vs. 70%.

The ongoing transmission of SARS-CoV-2 and the emergence of variants of concern may promote continued outbreaks of MIS-C in the and internationally. Until published data that define best practices are available, these data provide clinicians with additional evidence to guide treatment for the disease. Additional evidence-based studies are needed to examine the generalizability of these findings across a range of geographic regions and practice settings.

Source:
https://www.nejm.org/doi/10.1056/NEJMoa2102605
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