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Trends in Treatments for Multisystem Inflammatory Syndrome in Children (MIS-C), United States, February 2020 - July 2021.
Abrams, Joseph Y; Belay, Ermias D; Godfred-Cato, Shana; Campbell, Angela P; Zambrano, Laura D; Kunkel, Amber; Miller, Allison D; Wu, Michael J; Meng, Lu; Shah, Ami B; Oster, Matthew E.
  • Abrams JY; CDC COVID-19 Response Team, Atlanta, Georgia, USA.
  • Belay ED; CDC COVID-19 Response Team, Atlanta, Georgia, USA.
  • Godfred-Cato S; CDC COVID-19 Response Team, Atlanta, Georgia, USA.
  • Campbell AP; CDC COVID-19 Response Team, Atlanta, Georgia, USA.
  • Zambrano LD; CDC COVID-19 Response Team, Atlanta, Georgia, USA.
  • Kunkel A; CDC COVID-19 Response Team, Atlanta, Georgia, USA.
  • Miller AD; CDC COVID-19 Response Team, Atlanta, Georgia, USA.
  • Wu MJ; CDC COVID-19 Response Team, Atlanta, Georgia, USA.
  • Meng L; CDC COVID-19 Response Team, Atlanta, Georgia, USA.
  • Shah AB; Apex Systems Affiliated with General Dynamics Information Technology, Atlanta, Georgia, USA.
  • Oster ME; CDC COVID-19 Response Team, Atlanta, Georgia, USA.
Clin Infect Dis ; 75(7): 1201-1209, 2022 Sep 30.
Article in English | MEDLINE | ID: covidwho-1769229
ABSTRACT

BACKGROUND:

Multisystem inflammatory syndrome in children (MIS-C) is a novel severe postinfectious condition associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The purpose of this report is to describe nationwide trends in the evolving clinical management of MIS-C.

METHODS:

Patients with MIS-C were reported from state and local jurisdictions to the Centers for Disease Control and Prevention's (CDC's) MIS-C national surveillance system. Patients' case reports were reviewed to ensure that they met the CDC MIS-C case definition and had sufficient data for analysis. The prevalence of use of treatments for MIS-C, temporal trends in use of these treatments, and frequency of administration of different treatment combinations were analyzed.

RESULTS:

There were 4470 patients meeting the MIS-C case definition with onset dates from 19 February 2020 to 31 July 2021. The proportion of patients admitted to an intensive care unit (ICU) has declined over time, from 78.7% in April 2020 to 57.5% in June 2021 (P = .001). The most common treatments were intravenous immunoglobulin (IVIG), given to 85.6% of patients; steroids (77.7%), and antiplatelet medications (73.7%); use of each of these treatments has increased over time, particularly in patients not requiring admission to an ICU (all P < .001). Older patients and non-Hispanic Black patients were more likely to receive additional modes of therapy including vasoactive medication, noninvasive respiratory support, anticoagulation medication, and intubation/mechanical ventilation.

CONCLUSIONS:

IVIG, steroids, and antiplatelet medication have become increasingly utilized as standard treatment for MIS-C patients, while the use of other treatments may be contingent on the type and severity of clinical findings.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Child / Humans Country/Region as subject: North America Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2022 Document Type: Article Affiliation country: Cid

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Child / Humans Country/Region as subject: North America Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2022 Document Type: Article Affiliation country: Cid