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This is a Human Clinical Trial study.

August 25, 2025Open Access

Comparison of Immunomodulatory Therapies for Cardiovascular Clinical and Inflammatory Markers Outcomes in Mild to Moderately Ill Hospitalized Multisystem Inflammatory Syndrome in Children Patients

RDRashmitha DachepallyChildren's Hospital & Medical Center RSReem SarkisAkron Children's Hospital ADAlvaro DonaireGarciaThe University of Texas Rio Grande Valley

Key Points

Combined IVIG and corticosteroids therapy improved cardiovascular clinical parameters early in treatment, showing favorable outcomes.
Group B experienced a significant heart rate reduction of 17.8 and improvement in mean blood pressure by day 1, indicating effectiveness.
Assessment compared hospitalized mild to moderately ill MIS-C patients receiving either therapy over short-term durations from April 2020 to March 2022.
This approach suggests that IVIG plus corticosteroids may enhance treatment efficacy for MIS-C, while requiring fewer additional therapies.

Abstract

Optimal treatment for non-critically ill multisystem inflammatory syndrome in children (MIS-C) remains unclear. We evaluated short-term outcomes in mild to moderately ill hospitalized MIS-C patients fulfilling CDC 2020 and CDC/CTSE 2023 criteria and treated between April 2020 and March 2022 with either intravenous immunoglobulin (IVIG) monotherapy (Group A, n = 17) or IVIG plus corticosteroids (GC) (Group B, n = 22). Cardiovascular clinical parameters, inflammatory markers, and cardiac imaging were compared on days 1, 3, and 5 relative to day 0. The two groups had no significant differences in demographics or illness severity. Group B showed improvement in heart rate (17.8; 95% CI 9.74, 25.8), mean blood pressure (5.63 1.61, 9.64), and body temperature (1.45 0.94, 1.95) by day 1, followed by improvement in albumin (0.43 0.2, 0.84), CRP (7.56 3.0, 12.11), D-dimer (2344 488.7, 4200.2), ferritin (1448 −609.4, 3505.5), fibrinogen (110 44.4, 176), lymphocyte count (1006 63.5, 1948), and NT-proBNP (2901 −349.3, 6153) by day 3 and left ventricular ejection fraction by day 4–5 (3.84 0.55, 8.23). All results were statistically significant (p < 0.05). Group A required more additional therapies, with no difference in hospital stay. Our study concludes that combined IVIG and GC therapy yielded better short-term outcomes than IVIG monotherapy in this patient population, with improvement in cardiovascular clinical parameters preceding changes in inflammatory markers and cardiac imaging.

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