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Factors Associated with Pulse Methylprednisolone Treatment Failure in COVID-19-Related Multisystem Inflammatory Syndrome in Children (MIS-C)
Journal of Pediatric Infectious Diseases ; 2022.
Article in English | Web of Science | ID: covidwho-2042376
ABSTRACT
Objective This article determines the occurrence and variables associated with pulse methylprednisolone treatment failure in children with coronavirus disease 2019 (COVID-19)-related multisystem inflammatory syndrome in children (MIS-C). Methods This prospective observational study was undertaken at a tertiary care teaching hospital in Kerala, India. Children admitted with COVID-19-related MIS-C who were treated with pulse methylprednisolone as first-line therapy were included in the study. Depending on the response to the treatment, they were divided into two groups. The clinical, laboratory parameters, and follow-up findings at 3 months were compared between the two groups Results Seventy-six patients were admitted with MIS-C during the study period. Sixty received pulse methylprednisolone as the first-line therapy. Of the 60 patients who received pulse methylprednisolone, 50 responded to treatment, while 10 required repeat immunomodulation. Need for noninvasive or invasive ventilation (relative risk [RR] 13.14, 95% confidence interval [CI] 3.147-54.88), six or more organ involvement (RR 4.667, 95% CI 1.349-16.149), thrombocytopenia (RR 6.43, 95% CI 0.87-47.6, p 0.003), and abnormal chest X-ray findings at admission (RR 4.5, 95% CI 1.46-13.8), were found to be associated with increased risk of treatment failure with pulse methylprednisolone therapy. Note that 88% of patients with coronary artery involvement showed resolution at 3-month follow-up. Conclusion More than 80% of children with MIS-C can be treated successfully with corticosteroids. The need for ventilator support, abnormal chest X-ray findings, and thrombocytopenia at admission were found to be factors associated with pulse methylprednisolone treatment failure.
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Full text: Available Collection: Databases of international organizations Database: Web of Science Language: English Journal: Journal of Pediatric Infectious Diseases Year: 2022 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: Web of Science Language: English Journal: Journal of Pediatric Infectious Diseases Year: 2022 Document Type: Article