Early Intervention in Multisystem Inflammatory Syndrome in Children

Multisystem Inflammatory Syndrome in Children (MIS-C) – a severe hyperinflammatory condition that can occur after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, has a distinct immunologic phenotype identical to Kawasaki disease (KD), but affecting a broader age range. Evidence suggests potential benefits of intravenous immunoglobulin (IVIG) and glucocorticoids in treating MIS-C. 

A new study aimed to investigate if early glucocorticoid treatment could reduce the length of hospital stay. 

This was a multicenter, retrospective cohort study involving 131 MIS-C patients. Those who received glucocorticoids within 48 hours of hospitalization were compared to those who did not. The primary outcome measured was the hospital length of stay, with secondary outcomes including the length of stay in the ICU.

The results showed that patients who received glucocorticoids early were more likely to also receive early IVIG and require ICU admission. Early glucocorticoid treatment was associated with a shorter ICU stay in the unadjusted analysis. After adjusting for potential confounding factors, early glucocorticoid and IVIG administration were independently associated with a shorter hospital stay.

Thus, early interventions – with glucocorticoids and IVIG, were found to be associated with a shorter hospital stay in MIS-C patients despite the disease severity and other potential factors. Further research is needed to determine the optimal dosage and duration of treatment for MIS-C. The findings suggest that a combination of IVIG and glucocorticoids administered shortly after MIS-C diagnosis may be beneficial.

Source: Jonat B, Geneslaw AS, Capone CA, Shah S, Bartucca L, Sewell TB, Acker KP, Mitchell E, Cheung EW. Pediatrics. 2023 Sep 1;152(3).