Treatment of multisystem inflammatory syndrome in children

World J Pediatr. 2024 Apr;20(4):325-339. doi: 10.1007/s12519-024-00798-y. Epub 2024 Mar 21.

Abstract

Background: Multisystem inflammatory syndrome in children (MIS-C), a relatively uncommon but severe pediatric complication, is associated with coronavirus disease 2019 (COVID-19). A variety of treatment approaches, including intravenous immunoglobulins (IVIGs), glucocorticoids (GCs) and biologic agents, such as anakinra and infliximab, have been described for the management of COVID-19-related MIS-C. Anticoagulant therapy is also important. However, a well-developed treatment system has not been established, and many issues remain controversial. Several recently published articles related to the treatment of MIS-C have been released. Hence, in this review, we identified relevant articles published recently and summarized the treatment of MIS-C more comprehensively and systematically.

Data sources: We reviewed the literature on the treatment of MIS-C through 20 September 2023. The PubMed/Medline, Web of Science, EMBASE, and Cochrane Library databases were searched with the combination of the terms "multisystem inflammatory syndrome", "MIS-C", "PIMS-TS", "therapy", "treatment", "drug", "IVIG", "GCs", "intravenous immunoglobulin", "corticosteroids", "biological agent", and "aspirin".

Results: The severity of MIS-C varies, and different treatment schemes should be used according to the specific condition. Ongoing research and data collection are vital to better understand the pathophysiology and optimal management of MIS-C.

Conclusions: MIS-C is a disease involving multiple systems and has great heterogeneity. With the accumulation of additional experience, we have garnered fresh insights into its treatment strategies. However, there remains a critical need for greater standardization in treatment protocols, alongside the pressing necessity for more robust and meticulously conducted studies to deepen our understanding of these protocols. Supplementary file1 (MP4 208044 kb).

Keywords: Coronavirus disease 2019; Corticosteroids; Intravenous immunoglobulin; Multisystem inflammatory syndrome in children; Treatment.

Publication types

  • Review

MeSH terms

  • COVID-19 Drug Treatment
  • COVID-19* / complications*
  • Child
  • Glucocorticoids* / therapeutic use
  • Humans
  • Immunoglobulins, Intravenous* / therapeutic use
  • Systemic Inflammatory Response Syndrome* / diagnosis
  • Systemic Inflammatory Response Syndrome* / drug therapy

Substances

  • Immunoglobulins, Intravenous
  • Glucocorticoids

Supplementary concepts

  • pediatric multisystem inflammatory disease, COVID-19 related