Table 2 Management of patients with MIS-C stratified by MIS-C phenotypes.
From: Multisystem Inflammatory Syndrome in Children with tailored therapy and six-month outcome
Characteristic | Overall, N = 125a | Fever and Inflammation, N = 21a | KD, N = 57a | Shock, N = 47a | p-value |
|---|---|---|---|---|---|
Management | |||||
Length of hospitalization | 6.0 (5.0–7.0) | 5.0 (4.0–6.0) | 5.0 (4.0–6.0) | 7.0 (6.0–8.5) | <0.001b |
PICU | 34 (27%) | 1 (4.8%) | 1 (1.8%) | 32 (68%) | <0.001c |
Respiratory support | 27 (22%) | 1 (4.8%) | 0 (0%) | 26 (55%) | <0.001d |
Max Respiratory support | 0.6d | ||||
Nasal oxygen | 9/27 (33%) | 1/1 (100%) | 0/0 (NA%) | 8/26 (31%) | |
NIMV | 11/27 (41%) | 0/1 (0%) | 0/0 (NA%) | 11/26 (42%) | |
IMV | 7/27 (26%) | 0/1 (0%) | 0/0 (NA%) | 7/26 (27%) | |
Inotropic agent | 43 (34%) | 0 (0%) | 0 (0%) | 43 (91%) | <0.001c |
IVIG | 125 (100%) | 21 (100%) | 57 (100%) | 47 (100%) | |
Second IVIG | 7 (5.6%) | 0 (0%) | 0 (0%) | 7 (15%) | 0.002d |
Immunomodulatory treatment | <0.001d | ||||
Only IVIG | 4/125 (3.2%) | 1/21 (4.8%) | 3/57 (5.3%) | 0 (0%) | |
MP+IVIG | 45/125 (36%) | 11/21 (52%) | 31/57 (57%) | 3/47 (6.4%) | |
MP+IVIG+ Anakinra | 46/125 (37%) | 9/21 (43%) | 22/57 (41%) | 15/47 (32%) | |
MP+IVIG+ Anakinra + therapeutic plasma exchange | 30/125 (21%) | 0/21 (0%) | 1/57 (1.8%) | 29/47 (62%) | |
IVMP | 121 (97%) | 20 (95%) | 54 (95%) | 47 (100%) | 0.3d |
IVMP dose | <0.001d | ||||
High dose (5–30 mg/kg/d) | 29/121 (24%) | 0/20 (0%) | 7/54 (13%) | 22/47 (47%) | |
Low dose (1–4 mg/kg/d) | 92/121 (76%) | 20/20 (100%) | 47/54 (87%) | 25/47 (53%) | |
Cumulative IVMP dose | 11 (8–18) | 8 (6–9) | 12 (8–18) | 15 (8–32) | 0.001b |
Duration IVMP (Days) | 6 (5–7) | 5 (4–5) | 5 (4–6) | 7 (5–9) | <0.001b |
Oral prednisolone at discharge | 14 (11%) | 2 (9.5%) | 7 (12%) | 5 (11%) | >0.9d |
Anakinra | 76 (61%) | 9 (43%) | 23 (40%) | 44 (94%) | <0.001c |
Duration of Anakinra | 4 (3–5) | 3 (3–4) | 4 (3–5) | 5 (4–5) | 0.070b |
Plasma Exchange | 31 (25%) | 0 (0%) | 1 (1.8%) | 30 (64%) | <0.001c |
Enoxaparin | 119 (95%) | 18 (86%) | 55 (96%) | 46 (98%) | 0.14d |
Acetylsalicylic acid | 109 (87%) | 19 (90%) | 52 (91%) | 38 (81%) | 0.3d |
Antibiotics | 118 (94%) | 20 (95%) | 51 (89%) | 47 (100%) | 0.053d |
Favipiravir | 109 (87%) | 17 (81%) | 48 (84%) | 44 (94%) | 0.2d |
Insulin | 20 (16%) | 0 (0%) | 1 (1.8%) | 19 (40%) | <0.001d |
Any blood product | 37 (30%) | 1 (4.8%) | 4 (7.0%) | 32 (68%) | <0.001c |
Albumin | 28 (22%) | 1 (4.8%) | 2 (3.5%) | 25 (53%) | <0.001d |
Fresh frozen plasma | 24 (19%) | 0 (0%) | 0 (0%) | 24 (51%) | <0.001d |
Transfusion | 0.4d | ||||
Erythrocyte | 8/10 (80%) | 0/0 | 1/2 (50%) | 7/8 (88%) | NA |
Thrombocyte | 2/10 (20%) | 0/0 | 1/2 (50%) | 1/8 (13%) | NA |
