Methylprednisolone - The Savior in Children With Multisystem Inflammatory Syndrome (Mis-C)

Abstract

Background: Multisystem inammatory syndrome in children (MIS-C), also known as pediatric inammatory multisystem syndrome is a new entity and is fatal disease that is temporally associated with SARS-COV 2 (PIMS-TS) [1]. We aimed at studying varied clinical presentation, management and outcome in children with MIS-C associated with covid-19 treated with IvIg and methylprednisolone at tertiary care centre, Davangere. This is a retrospective observational Methods: study conducted at two tertiary care hospitals at Davangere from October 2020 to August 2021 (11 months.). All cases who fullled WHO criteria for MIS-C were included in the study. Institutional ethics committee approval was taken. Data was obtained from hospital records .Parameters studied were demographics, symptomatology, laboratory markers, medications and immediate outcome. All children were then grouped into 2. Group 1- those who presented with shock and group 2- those who presented without shock . Data were entered and analyzed using SPSS software version 22.0. For interpretation of results signicance was adopted at p-value less than 0.005 and at 95% condence interval. A total of 182 patients w Results: ith MIS-C were treated during the study period. The median age of presentation was 6.8±4.5 years. We had 14 cases of infants. M:F ratio 1.35:1 showing no sex predilection. Children who presented with shock had signicant symptoms of pain abdomen, tachypnoea, Lower GCS and lower saturation levels and had signicantly higher CRP, LDH, ferritin, D-dimer levels and had lower albumin levels which is statistically signicant . Also requirement of IVIg was signicantly more in children with shock (TABLE 2). Out of 182 children with MIS-C, only 21 received IVIg and rest all received only steroids - methylprednisolone ( due to nancial constraints ). However the outcome did not vary much with IVIg or steroids. IV methylprednisolone pulse therapy was associated with favorable immediate outcome which is comparable with IVIg in our study. Mortality in our series was 6.04% which is comparable to international studies [11,12]. In our Conclusion study most of our children with MIS-C recovered with timely use of pulse methylprednisolone therapy alone with favourable short term outcomes. Thus in resource limited settings methylprednisolone pulse therapy can help in saving lot of young children with MISC.