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Treatment of MIS-C in Children and Adolescents

PURPOSE OF REVIEW: Different treatment approaches have been described for the management of COVID-19-related multisystem inflammatory syndrome in children (MIS-C), the pathogenesis of which has not yet been fully elucidated. Here, we comprehensively review and summarize the recommendations and manag...

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Autores principales: Mahmoud, Sanaa, El-Kalliny, Mostafa, Kotby, Alyaa, El-Ganzoury, Mona, Fouda, Eman, Ibrahim, Hanan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8741532/
https://www.ncbi.nlm.nih.gov/pubmed/35036079
http://dx.doi.org/10.1007/s40124-021-00259-4
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author Mahmoud, Sanaa
El-Kalliny, Mostafa
Kotby, Alyaa
El-Ganzoury, Mona
Fouda, Eman
Ibrahim, Hanan
author_facet Mahmoud, Sanaa
El-Kalliny, Mostafa
Kotby, Alyaa
El-Ganzoury, Mona
Fouda, Eman
Ibrahim, Hanan
author_sort Mahmoud, Sanaa
collection PubMed
description PURPOSE OF REVIEW: Different treatment approaches have been described for the management of COVID-19-related multisystem inflammatory syndrome in children (MIS-C), the pathogenesis of which has not yet been fully elucidated. Here, we comprehensively review and summarize the recommendations and management strategies that have been published to date. RECENT FINDINGS: MIS-C patients are treated with different regimens, mostly revolving around the use of immunomodulatory medications, including IVIG and glucocorticoids as first-tier therapy. Refractoriness to IVIG and glucocorticoids warrants a step-up of immunomodulatory therapy to biologic agents such as anakinra, tocilizumab, and infliximab. SUMMARY: We review the current evidence regarding the use of monotherapy versus combination therapy, as well as the current recommendations for assessing thrombotic risk and administering antiplatelet and anticoagulant therapy. We anticipate that future studies will provide evidence for management plans that maximize short- and long-term outcomes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40124-021-00259-4.
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spelling pubmed-87415322022-01-10 Treatment of MIS-C in Children and Adolescents Mahmoud, Sanaa El-Kalliny, Mostafa Kotby, Alyaa El-Ganzoury, Mona Fouda, Eman Ibrahim, Hanan Curr Pediatr Rep Critical Care (R Pierce, Section Editor) PURPOSE OF REVIEW: Different treatment approaches have been described for the management of COVID-19-related multisystem inflammatory syndrome in children (MIS-C), the pathogenesis of which has not yet been fully elucidated. Here, we comprehensively review and summarize the recommendations and management strategies that have been published to date. RECENT FINDINGS: MIS-C patients are treated with different regimens, mostly revolving around the use of immunomodulatory medications, including IVIG and glucocorticoids as first-tier therapy. Refractoriness to IVIG and glucocorticoids warrants a step-up of immunomodulatory therapy to biologic agents such as anakinra, tocilizumab, and infliximab. SUMMARY: We review the current evidence regarding the use of monotherapy versus combination therapy, as well as the current recommendations for assessing thrombotic risk and administering antiplatelet and anticoagulant therapy. We anticipate that future studies will provide evidence for management plans that maximize short- and long-term outcomes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40124-021-00259-4. Springer US 2022-01-08 2022 /pmc/articles/PMC8741532/ /pubmed/35036079 http://dx.doi.org/10.1007/s40124-021-00259-4 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Critical Care (R Pierce, Section Editor)
Mahmoud, Sanaa
El-Kalliny, Mostafa
Kotby, Alyaa
El-Ganzoury, Mona
Fouda, Eman
Ibrahim, Hanan
Treatment of MIS-C in Children and Adolescents
title Treatment of MIS-C in Children and Adolescents
title_full Treatment of MIS-C in Children and Adolescents
title_fullStr Treatment of MIS-C in Children and Adolescents
title_full_unstemmed Treatment of MIS-C in Children and Adolescents
title_short Treatment of MIS-C in Children and Adolescents
title_sort treatment of mis-c in children and adolescents
topic Critical Care (R Pierce, Section Editor)
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8741532/
https://www.ncbi.nlm.nih.gov/pubmed/35036079
http://dx.doi.org/10.1007/s40124-021-00259-4
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