Initial Immunomodulation and Outcome of Children with Multisystem Inflammatory Syndrome Related to COVID-19 : A Multisite Study from India
© 2022. The Author(s), under exclusive licence to Dr. K C Chaudhuri Foundation..
OBJECTIVE: To determine the outcomes in children with MIS-C receiving different immunomodulatory treatment.
METHODS: In this multicentric, retrospective cohort study, data regarding treatment and outcomes of children meeting the WHO case definition 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 different 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 definition 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 fifty-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 significant difference was observed in the frequency of occurrence of the primary outcome in different treatment groups, data from adequately powered RCTs are required for definitive recommendations.
Medienart: |
E-Artikel |
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Erscheinungsjahr: |
2022 |
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Erschienen: |
2022 |
Enthalten in: |
Zur Gesamtaufnahme - volume:89 |
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Enthalten in: |
Indian journal of pediatrics - 89(2022), 12 vom: 14. Dez., Seite 1236-1242 |
Sprache: |
Englisch |
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Beteiligte Personen: |
Bagri, Narendra Kumar [VerfasserIn] |
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Links: |
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Themen: |
COVID-19 |
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Anmerkungen: |
Date Completed 25.11.2022 Date Revised 28.11.2022 published: Print-Electronic Citation Status MEDLINE |
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doi: |
10.1007/s12098-022-04254-5 |
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funding: |
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Förderinstitution / Projekttitel: |
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PPN (Katalog-ID): |
NLM342213989 |
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100 | 1 | |a Bagri, Narendra Kumar |e verfasserin |4 aut | |
245 | 1 | 0 | |a Initial Immunomodulation and Outcome of Children with Multisystem Inflammatory Syndrome Related to COVID-19 |b A Multisite Study from India |
264 | 1 | |c 2022 | |
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500 | |a Date Revised 28.11.2022 | ||
500 | |a published: Print-Electronic | ||
500 | |a Citation Status MEDLINE | ||
520 | |a © 2022. The Author(s), under exclusive licence to Dr. K C Chaudhuri Foundation. | ||
520 | |a OBJECTIVE: To determine the outcomes in children with MIS-C receiving different immunomodulatory treatment | ||
520 | |a METHODS: In this multicentric, retrospective cohort study, data regarding treatment and outcomes of children meeting the WHO case definition 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 different treatment arms based on the initial immunomodulation, i.e., IVIG alone, IVIG plus steroids, and steroids alone | ||
520 | |a RESULTS: The data of 368 children (diagnosed between April 2020 and June 2021) meeting the WHO case definition 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 fifty-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) | ||
520 | |a CONCLUSION: While no significant difference was observed in the frequency of occurrence of the primary outcome in different treatment groups, data from adequately powered RCTs are required for definitive recommendations | ||
650 | 4 | |a Multicenter Study | |
650 | 4 | |a Journal Article | |
650 | 4 | |a COVID-19 | |
650 | 4 | |a IVIG | |
650 | 4 | |a MIS-C | |
650 | 4 | |a Outcome | |
650 | 4 | |a Propensity scoring | |
650 | 4 | |a Resource-poor setting, Steroids | |
650 | 4 | |a Treatment modality | |
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650 | 7 | |a Steroids |2 NLM | |
700 | 1 | |a Khan, M |e verfasserin |4 aut | |
700 | 1 | |a Pandey, R M |e verfasserin |4 aut | |
700 | 1 | |a Lodha, Rakesh |e verfasserin |4 aut | |
700 | 1 | |a Kabra, S K |e verfasserin |4 aut | |
700 | 0 | |a MIS-C study group |e verfasserin |4 aut | |
700 | 1 | |a Angurana, Suresh Kumar |e investigator |4 oth | |
700 | 1 | |a Awasthi, Shally |e investigator |4 oth | |
700 | 1 | |a Bamnawat, Harshita |e investigator |4 oth | |
700 | 1 | |a Bhat, Javeed Iqbal |e investigator |4 oth | |
700 | 1 | |a Bhutia, Tsultem D |e investigator |4 oth | |
700 | 1 | |a Charoo, Bashir Ahmad |e investigator |4 oth | |
700 | 1 | |a Choudhary, Abhijit |e investigator |4 oth | |
700 | 1 | |a Choudhary, Bharat |e investigator |4 oth | |
700 | 1 | |a Das, Rashmi Ranjan |e investigator |4 oth | |
700 | 1 | |a Dwibedi, Bhagirathi |e investigator |4 oth | |
700 | 1 | |a Ghosh, Sanajit |e investigator |4 oth | |
700 | 1 | |a Girish, Meenakshi |e investigator |4 oth | |
700 | 1 | |a Gulla, Krishna Mohan |e investigator |4 oth | |
700 | 1 | |a Goyal, Jagdish Prasad |e investigator |4 oth | |
700 | 1 | |a Gupta, Prakriti |e investigator |4 oth | |
700 | 1 | |a I, Shivanand |e investigator |4 oth | |
700 | 1 | |a Jindal, Atul |e investigator |4 oth | |
700 | 1 | |a John, Joseph |e investigator |4 oth | |
700 | 1 | |a Joshi, Preetha |e investigator |4 oth | |
700 | 1 | |a Kaur, Ravleen |e investigator |4 oth | |
700 | 1 | |a Khera, Daisy |e investigator |4 oth | |
700 | 1 | |a Kumar, Amit |e investigator |4 oth | |
700 | 1 | |a Kumar, Pradeep |e investigator |4 oth | |
700 | 1 | |a Kumar, Prawin |e investigator |4 oth | |
700 | 1 | |a Lalitha, A V |e investigator |4 oth | |
700 | 1 | |a Maheshwari, Mahesh |e investigator |4 oth | |
700 | 1 | |a Malik, Shikha |e investigator |4 oth | |
700 | 1 | |a Mondal, Rakesh |e investigator |4 oth | |
700 | 1 | |a Muralidharan, Jayashree |e investigator |4 oth | |
700 | 1 | |a Pawar, Gayatri |e investigator |4 oth | |
700 | 1 | |a Prasad, Arun |e investigator |4 oth | |
700 | 1 | |a Rao, Sunil Kumar |e investigator |4 oth | |
700 | 1 | |a Ratageri, Vinod H |e investigator |4 oth | |
700 | 1 | |a Sarkar, Mihir |e investigator |4 oth | |
700 | 1 | |a Satpathy, Amit Kumar |e investigator |4 oth | |
700 | 1 | |a Sankar, Jhuma |e investigator |4 oth | |
700 | 1 | |a Sharma, Seema |e investigator |4 oth | |
700 | 1 | |a Singh, Ankur |e investigator |4 oth | |
700 | 1 | |a Singh, Kuldeep |e investigator |4 oth | |
700 | 1 | |a Singhal, Tanu |e investigator |4 oth | |
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700 | 1 | |a Tiwari, Lokesh |e investigator |4 oth | |
700 | 1 | |a Verma, Nishant |e investigator |4 oth | |
700 | 1 | |a Yonzon, Ruth |e investigator |4 oth | |
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