Initial Immunomodulation and Outcome of Children with Multisystem Inflammatory Syndrome Related to COVID-19: A Multisite Study from India

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dc.contributor.authorBagri, Narendra Kumaren_US
dc.contributor.authorKhan, M.en_US
dc.contributor.authorPandey, R. M.en_US
dc.contributor.authorLodha, Rakeshen_US
dc.contributor.authorKabra, S. K.en_US
dc.contributor.authorMIS-C study groupen_US
dc.date.accessioned2023-08-19T04:53:37Z
dc.date.available2023-08-19T04:53:37Z
dc.date.issued2022-12
dc.description.abstractObjective To determine the outcomes in children with MIS-C receiving diferent immunomodulatory treatment. Methods In this multicentric, retrospective cohort study, data regarding treatment and outcomes of children meeting the WHO case defnition for MIS-C, were collected. The primary composite outcome was the requirement of vasoactive/inotropic support on day 2 or beyond or need of mechanical ventilation on day 2 or beyond after initiation of immunomodulatory treatment or death during hospitalization in the treatment groups. Logistic regression and propensity score matching analyses were used to compare the outcomes in diferent treatment arms based on the initial immunomodulation, i.e., IVIG alone, IVIG plus steroids, and steroids alone. Results The data of 368 children (diagnosed between April 2020 and June 2021) meeting the WHO case defnition for MIS-C, were analyzed. Of the 368 subjects, 28 received IVIG alone, 82 received steroids alone, 237 received IVIG and steroids, and 21 did not receive any immunomodulation. One hundred ffty-six (42.39%) children had the primary outcome. On logistic regression analysis, the treatment group was not associated with the primary outcome; only the children with shock at diagnosis had higher odds for the occurrence of the outcome [OR (95% CI): 11.4 (5.19–25.0), p<0.001]. On propensity score matching analysis, the primary outcome was comparable in steroid (n=45), and IVIG plus steroid (n=84) groups (p=0.515). Conclusion While no signifcant diference was observed in the frequency of occurrence of the primary outcome in diferent treatment groups, data from adequately powered RCTs are required for defnitive recommendations.en_US
dc.identifier.affiliationsDepartment of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, Indiaen_US
dc.identifier.affiliationsDepartment of Biostatistics, All India Institute of Medical Sciences, New Delhi, Indiaen_US
dc.identifier.citationBagri Narendra Kumar, Khan M., Pandey R. M., Lodha Rakesh, Kabra S. K., MIS-C study group. Initial Immunomodulation and Outcome of Children with Multisystem Inflammatory Syndrome Related to COVID-19: A Multisite Study from India. Indian Journal of Pediatrics. 2022 Dec; 89(12): 1236–1242en_US
dc.identifier.issn0973-7693
dc.identifier.issn0019-5456
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/223741
dc.languageenen_US
dc.publisherDr. K C Chaudhuri Foundationen_US
dc.relation.issuenumber12en_US
dc.relation.volume89en_US
dc.source.urihttps://doi.org/10.1007/s12098-022-04254-5en_US
dc.subjectCOVID-19en_US
dc.subjectIVIGen_US
dc.subjectMIS-Cen_US
dc.subjectOutcomeen_US
dc.subjectPropensity scoringen_US
dc.subjectResource-poor setting, Steroidsen_US
dc.subjectTreatment modalityen_US
dc.titleInitial Immunomodulation and Outcome of Children with Multisystem Inflammatory Syndrome Related to COVID-19: A Multisite Study from Indiaen_US
dc.typeJournal Articleen_US
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