The Role of Glucocorticoids in the Treatment of Multisystem Inflammatory Syndrome (MIS-C)-Data from POLISH MIS-C Registry

Ewelina Gowin; Kacper Toczyłowski; Artur Sulik; Jacek Wysocki; Danuta Januszkiewicz-Lewandowska

doi:10.3390/children9020178

The Role of Glucocorticoids in the Treatment of Multisystem Inflammatory Syndrome (MIS-C)-Data from POLISH MIS-C Registry

Children (Basel). 2022 Feb 1;9(2):178. doi: 10.3390/children9020178.

Authors

Ewelina Gowin¹, Kacper Toczyłowski², Artur Sulik², Jacek Wysocki¹, Danuta Januszkiewicz-Lewandowska³

Affiliations

¹ Health Promotion Department, Poznan University of Medical Sciences, Fredry 10, 61-701 Poznan, Poland.
² Department of Pediatric Infectious Diseases, Medical University of Bialystok, Waszyngtona 17, 15-274 Bialystok, Poland.
³ Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, Szpitalna 27/33, 60-572 Poznan, Poland.

Abstract

Background: Multisystem inflammatory syndrome (MIS-C) is a condition related to COVID-19. It's most significant feature is cardiac involvement.

Methods: We have analyzed data from 42 hospitals in the Polish MIS-C Registry. To compare the effect of GCS on fever, we formed two groups: the first treated with IVIG and the second treated with IVIG+GCS.

Results: There were 111 boys and 56 girls; the mean age was 8.57 years. All the patients were treated with IVIG: 76 patients with IVIG only, and 91 patients with IVIG+GCS. There were no statistically significant differences between the groups regarding age, gender, BMI, or inflammatory markers. Methylprednisolone was the most common drug (80%). Echocardiographic abnormalities on admission were more prevalent in the IVIG+GCS group. Mean time from IVIG infusion to subsidence of fever was 1.1 days, and 1.5 for those in the IVIG+GCS group.

Conclusions: GCS are commonly used in the treatment of MIS-C patients in Poland. Various GCS regimens are used, from a single dose to a month-long therapy. Children with lower lymphocyte levels and cardiac abnormalities on an echocardiographic examination performed on admission were more likely to receive GCS+IVIG. The effect of GCS is difficult to access as patients were not randomly assigned to receive the treatment.

Keywords: Kawasaki disease; fever; multisystem inflammatory syndrome (MIS-C).