2 studies divided on treatment for kids with rare COVID-19 complication

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The benefits of using a combination treatment for children who develop a rare inflammatory condition after contracting COVID-19 is still unclear, two new studies show.

The first study, published June 16 in The New England Journal of Medicine, included data on 518 patients with multisystem inflammatory syndrome in children, or MIS-C. The patients were treated at 58 U.S. hospitals between March 15 and Oct. 31, 2020.

Researchers at Boston Children's Hospitals led the study and found treatment with intravenous immune globulin therapy, or IVIG, and glucocorticoids was linked to a lower risk of cardiovascular dysfunction (17 percent) after two days compared to treatment with IVIG alone (31 percent). Patients receiving the combination treatment were also less likely to need additional treatments to boost their immune system than those taking IVIG alone. 

However, a second study also published June 16 in The New England Journal of Medicine offered different results. Researchers at the Imperial College London analyzed data on 614 patients with suspected MIS-C in 32 countries between June 20, 2020, and Feb. 14, 2021. 

They found 27 percent of patients receiving the combination therapy required ventilation or died, compared to 17.2 percent of those taking only glucocorticoids.

"We found no evidence that recovery from MIS-C differed after primary treatment with IVIG alone, IVIG plus glucocorticoids, or glucocorticoids alone, although significant differences may emerge as more data accrue," researchers wrote.

While the two studies offer conflicting results, they used data on different patient populations from different times of the pandemic, Roberta De Biasi, MD, chief of pediatric diseases at Children's National Hospital in Washington, D.C., said in a commentary accompanying the studies. 

"Although it is becoming increasingly clear that swift and decisive institution of immunomodulatory therapy can be lifesaving in patients with MIS-C, neither of these studies definitively answered the question about the most effective single or combination treatment," she wrote, adding that "clinicians must avoid the pitfall of interpreting a lack of data as a lack of efficacy." 

 

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