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.
Dachepally et al. (2025) studied this question.