Participants with clinical exposure to OMT before entering clinical training were more likely to plan to use OMT in future practice. Early clinical exposure to OMT before or during the first 2 years of osteopathic medical school was associated with a positive perception of OMT.

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Background and objective: Evidence for the treatment of multisystem inflammatory syndrome in children (MIS-C) is lacking. Anakinra, which targets IL-1-mediated inflammation, is reserved for refractory cases of MIS-C; however, its use in the treatment of MIS-C is not clearly established. Patients and Methods: To examine a role for anakinra in MIS-C, we performed a single center prospective observational cohort study of all MIS-C patients diagnosed at our children’s hospital from May 15 to November 15, 2020. Demographics, clinical features, diagnostic testing, and cardiac function parameters were compared between MIS-C patients treated with intravenous immunoglobulin (IVIG) monotherapy and IVIG with anakinra (IVIG+anakinra). Results: Among 46 patients with confirmed MIS-C, 32 (70%) were in the IVIG+anakinra group, of which 9 of these patients (28%) were also given corticosteroids (CS). No patients were treated with anakinra alone. MIS-C patients in the IVIG+anakinra group were enriched in a CV shock phenotype (p=0.02), and those with CV shock were treated with higher doses of anakinra for a longer duration. Furthermore, MIS-C patients in the IVIG+anakinra group exhibited improvements in fever and cardiac function with and without CS. No significant adverse events were observed, and no differences in IL-1β levels were found among MIS-C patients in the IVIG+anakinra group. Conclusions: Anakinra treatment, which was co-administered with IVIG and primarily in patients with severe MIS-C, was associated with improvements in fever and cardiac function, and demonstrated a favorable side-effect profile. These findings suggest a role for adjunctive anakinra in the treatment of MIS-C.