Association of Intravenous Immunoglobulins Plus Methylprednisolone vs Immunoglobulins Alone With Course of Fever in Multisystem Inflammatory Syndrome in Children

Abstract

Children account for only 1% to 2% of hospitalized patients with coronavirus disease 2019 (COVID-19).¹ However, in April 2020, severe systemic hyperinflammatory disease was reported in children in Europe and the United States, occurring 2 to 4 weeks after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.^2-6 This novel entity, named multisystem inflammatory syndrome in children (MIS-C)⁷ or pediatric multisystem inflammatory syndrome temporally associated with COVID-19,⁸ is associated with a wide range of clinical features including persistent fever, digestive symptoms, rash, bilateral nonpurulent conjunctivitis, mucocutaneous inflammation signs, and frequent cardiovascular involvement.^2,4-6,9 MIS-C is often associated with hemodynamic failure, with acute cardiac dysfunction requiring hemodynamic support in 60% to 75% of cases,^5,6 sometimes associated with death.^2-6