IVIG plus Glucocorticoids versus IVIG Alone in Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19: A Systematic Review and Meta-Analysis
Background. There is limited information available regarding the management of multisystem inflammatory syndrome in children (MIS-C) associated with SARS-CoV-2. We performed a systematic review and meta-analysis to evaluate the optimal treatment using IVIG alone versus IVIG plus glucocorticoids. Met...
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Canadian Journal of Infectious Diseases and Medical Microbiology |
| Online Access: | http://dx.doi.org/10.1155/2022/9458653 |
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| author | Robin Rauniyar Aman Mishra Sanjeev Kharel Subarna Giri Rohit Rauniyar Shikha Yadav Gajendra Chaudhary |
| author_facet | Robin Rauniyar Aman Mishra Sanjeev Kharel Subarna Giri Rohit Rauniyar Shikha Yadav Gajendra Chaudhary |
| author_sort | Robin Rauniyar |
| collection | DOAJ |
| description | Background. There is limited information available regarding the management of multisystem inflammatory syndrome in children (MIS-C) associated with SARS-CoV-2. We performed a systematic review and meta-analysis to evaluate the optimal treatment using IVIG alone versus IVIG plus glucocorticoids. Methods. PubMed, Google Scholar, EMBASE, and Cochrane databases were searched along with other secondary searches. Studies published within the time frame of January 2020 to August 2021 were included. We screened records, extracted data, and assessed the quality of the studies using NOS. Studies that directly compare the two treatment groups were included. Analyses were conducted using the random-effects model (DerSimonian-Laird analysis) if I2 > 50% and fixed-effects model was used if I2 < 50%. Results. We included three studies in the final quantitative analysis. The initial therapy with the IVIG plus glucocorticoids group significantly lowered the risk of treatment failure (OR 0.57, 95% CI (0.42, 0.79), I2 45.36%) and the need for adjunctive immunomodulatory therapy (OR 0.27, 95% CI (0.20, 0.37), I2 0.0%). The combination therapy showed no significant reduction in occurrence of left ventricular dysfunction (OR 0.79, 95% CI (0.34, 1.87), I2 58.44%) and the need for inotropic support (OR 0.83, 95% CI (0.35, 1.99), I2 75.40%). Conclusion. This study supports the use of IVIG with glucocorticoids compared to IVIG alone, as the combination therapy significantly lowered the risk of treatment failure and the need for adjunctive immunomodulatory therapy. |
| format | Article |
| id | doaj-art-39552e22c1224b48932be9854dee1ccd |
| institution | Kabale University |
| issn | 1918-1493 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Infectious Diseases and Medical Microbiology |
| spelling | doaj-art-39552e22c1224b48932be9854dee1ccd2025-02-03T01:07:01ZengWileyCanadian Journal of Infectious Diseases and Medical Microbiology1918-14932022-01-01202210.1155/2022/9458653IVIG plus Glucocorticoids versus IVIG Alone in Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19: A Systematic Review and Meta-AnalysisRobin Rauniyar0Aman Mishra1Sanjeev Kharel2Subarna Giri3Rohit Rauniyar4Shikha Yadav5Gajendra Chaudhary6Maharajgunj Medical CampusMaharajgunj Medical CampusMaharajgunj Medical CampusMaharajgunj Medical CampusInternal MedicineNepalgunj Medical CollegeMaharajgunj Medical CampusBackground. There is limited information available regarding the management of multisystem inflammatory syndrome in children (MIS-C) associated with SARS-CoV-2. We performed a systematic review and meta-analysis to evaluate the optimal treatment using IVIG alone versus IVIG plus glucocorticoids. Methods. PubMed, Google Scholar, EMBASE, and Cochrane databases were searched along with other secondary searches. Studies published within the time frame of January 2020 to August 2021 were included. We screened records, extracted data, and assessed the quality of the studies using NOS. Studies that directly compare the two treatment groups were included. Analyses were conducted using the random-effects model (DerSimonian-Laird analysis) if I2 > 50% and fixed-effects model was used if I2 < 50%. Results. We included three studies in the final quantitative analysis. The initial therapy with the IVIG plus glucocorticoids group significantly lowered the risk of treatment failure (OR 0.57, 95% CI (0.42, 0.79), I2 45.36%) and the need for adjunctive immunomodulatory therapy (OR 0.27, 95% CI (0.20, 0.37), I2 0.0%). The combination therapy showed no significant reduction in occurrence of left ventricular dysfunction (OR 0.79, 95% CI (0.34, 1.87), I2 58.44%) and the need for inotropic support (OR 0.83, 95% CI (0.35, 1.99), I2 75.40%). Conclusion. This study supports the use of IVIG with glucocorticoids compared to IVIG alone, as the combination therapy significantly lowered the risk of treatment failure and the need for adjunctive immunomodulatory therapy.http://dx.doi.org/10.1155/2022/9458653 |
| spellingShingle | Robin Rauniyar Aman Mishra Sanjeev Kharel Subarna Giri Rohit Rauniyar Shikha Yadav Gajendra Chaudhary IVIG plus Glucocorticoids versus IVIG Alone in Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19: A Systematic Review and Meta-Analysis Canadian Journal of Infectious Diseases and Medical Microbiology |
| title | IVIG plus Glucocorticoids versus IVIG Alone in Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19: A Systematic Review and Meta-Analysis |
| title_full | IVIG plus Glucocorticoids versus IVIG Alone in Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19: A Systematic Review and Meta-Analysis |
| title_fullStr | IVIG plus Glucocorticoids versus IVIG Alone in Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | IVIG plus Glucocorticoids versus IVIG Alone in Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19: A Systematic Review and Meta-Analysis |
| title_short | IVIG plus Glucocorticoids versus IVIG Alone in Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19: A Systematic Review and Meta-Analysis |
| title_sort | ivig plus glucocorticoids versus ivig alone in multisystem inflammatory syndrome in children mis c associated with covid 19 a systematic review and meta analysis |
| url | http://dx.doi.org/10.1155/2022/9458653 |
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