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Treatment of multisystem inflammatory syndrome in children
Tong Tong1, Yi-Hua Jin1, Min Wang1
1Department of Cardiology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, No. 3333 Binsheng Road, Hangzhou, 310052, China.
Insights
Multisystem inflammatory syndrome in children (MIS-C) is a severe COVID-19 complication. This review systematically summarizes recent MIS-C treatment strategies, highlighting the need for standardized protocols and further research.
Area of Science:
- Pediatric critical care medicine
- Infectious diseases
- Rheumatology
Background:
- Multisystem inflammatory syndrome in children (MIS-C) is a severe, though uncommon, pediatric complication linked to COVID-19.
- Current management strategies for MIS-C include intravenous immunoglobulins (IVIGs), glucocorticoids (GCs), biologic agents (e.g., anakinra, infliximab), and anticoagulant therapy.
- Despite various approaches, established treatment systems are lacking, and many aspects remain debated.
Purpose of the Study:
- To systematically review and summarize recent advancements in the treatment of COVID-19-related MIS-C.
- To provide a comprehensive overview of current therapeutic strategies based on the latest literature.
Main Methods:
- A literature search was conducted on PubMed/Medline, Web of Science, EMBASE, and Cochrane Library up to September 20, 2023.
- Keywords included "multisystem inflammatory syndrome", "MIS-C", "PIMS-TS", "therapy", "treatment", "drug", "IVIG", "GCs", "intravenous immunoglobulin", "corticosteroids", "biological agent", and "aspirin".
Main Results:
- The severity of MIS-C exhibits significant variability, necessitating tailored treatment regimens.
- Recent literature provides updated insights into managing this heterogeneous condition.
Conclusions:
- MIS-C is a complex, multi-system disease with considerable heterogeneity.
- Enhanced clinical experience offers new perspectives on treatment, but standardization of protocols and rigorous research are crucial.
- Further studies are essential to deepen the understanding and optimize management strategies for MIS-C.
Background:
Multisystem inflammatory syndrome in children (MIS-C), a relatively uncommon but severe pediatric complication, is associated with coronavirus disease 2019 (COVID-19). A variety of treatment approaches, including intravenous immunoglobulins (IVIGs), glucocorticoids (GCs) and biologic agents, such as anakinra and infliximab, have been described for the management of COVID-19-related MIS-C. Anticoagulant therapy is also important. However, a well-developed treatment system has not been established, and many issues remain controversial. Several recently published articles related to the treatment of MIS-C have been released. Hence, in this review, we identified relevant articles published recently and summarized the treatment of MIS-C more comprehensively and systematically.
Data Sources:
We reviewed the literature on the treatment of MIS-C through 20 September 2023. The PubMed/Medline, Web of Science, EMBASE, and Cochrane Library databases were searched with the combination of the terms "multisystem inflammatory syndrome", "MIS-C", "PIMS-TS", "therapy", "treatment", "drug", "IVIG", "GCs", "intravenous immunoglobulin", "corticosteroids", "biological agent", and "aspirin".
Results:
The severity of MIS-C varies, and different treatment schemes should be used according to the specific condition. Ongoing research and data collection are vital to better understand the pathophysiology and optimal management of MIS-C.
Conclusions:
MIS-C is a disease involving multiple systems and has great heterogeneity. With the accumulation of additional experience, we have garnered fresh insights into its treatment strategies. However, there remains a critical need for greater standardization in treatment protocols, alongside the pressing necessity for more robust and meticulously conducted studies to deepen our understanding of these protocols. Supplementary file1 (MP4 208044 kb).
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