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ABSTRACT: Background
Clinical management of multisystem inflammatory syndrome in children (MIS-C) has varied over time and by medical institution.Methods
Data on patients with MIS-C were collected from 4 children's hospitals between March 16, 2020 and March 10, 2021. Relationships between MIS-C treatments and patient demographics, clinical characteristics, and outcomes were described. Propensity score matching was utilized to assess the relative risk of outcomes dependent on early treatment with intravenous immunoglobulin (IVIG) or low-dose steroids, controlling for potential confounding variables.Results
Of 233 patients diagnosed with MIS-C, the most commonly administered treatments were steroids (88.4%), aspirin (81.1%), IVIG (77.7%) and anticoagulants (71.2%). Compared with those patients without respiratory features, patients with respiratory features were less likely to receive IVIG and steroids on the same day (combination treatment) (44.1%). Controlling for confounding variables, patients receiving IVIG within 1 day of hospitalization were less likely to have hospital length of stay ≥8 days (RR = 0.53, 95% CI: 0.31-0.88). Patients receiving low-dose steroids within 1 day of hospitalization were less likely to develop ventricular dysfunction (RR = 0.45, 95% CI: 0.26-0.77), have increasingly elevated troponin levels (RR = 0.55, 95% CI: 0.40-0.75) or have hospital length of stay ≥8 days (RR = 0.46, 95% CI: 0.29-0.74).Conclusion
Treatments for MIS-C differed by hospital, patient characteristics and illness severity. When IVIG and low-dose steroids were administered in combination or low-dose steroids were administered alone within 1 day of hospitalization, the risk of subsequent severe outcomes was decreased.
SUBMITTER: Shah AB
PROVIDER: S-EPMC11318085 | biostudies-literature | 2023 Nov
REPOSITORIES: biostudies-literature
Shah Ami B AB Abrams Joseph Y JY Godfred-Cato Shana S Kunkel Amber A Hammett Teresa A TA Perez Maria A MA Hsiao Hui-Mien HM Baida Nadine N Rostad Christina A CA Ballan Wassim W Ede Kaleo K Laham Federico R FR Kao Carol M CM Oster Matthew E ME Belay Ermias D ED
The Pediatric infectious disease journal 20231011 11
<h4>Background</h4>Clinical management of multisystem inflammatory syndrome in children (MIS-C) has varied over time and by medical institution.<h4>Methods</h4>Data on patients with MIS-C were collected from 4 children's hospitals between March 16, 2020 and March 10, 2021. Relationships between MIS-C treatments and patient demographics, clinical characteristics, and outcomes were described. Propensity score matching was utilized to assess the relative risk of outcomes dependent on early treatmen ...[more]