Background

Multisystem inflammatory syndrome in children (MIS-C), a relatively uncommon but severe pediatric complication, is associated with coronavirus disease 2019 (COVID-19). A variety of treatment approaches, including intravenous immunoglobulins (IVIGs), glucocorticoids (GCs) and biologic agents, such as anakinra and infliximab, have been described for the management of COVID-19-related MIS-C. Anticoagulant therapy is also important. However, a well-developed treatment system has not been established, and many issues remain controversial. Several recently published articles related to the treatment of MIS-C have been released. Hence, in this review, we identified relevant articles published recently and summarized the treatment of MIS-C more comprehensively and systematically.

Data sources

We reviewed the literature on the treatment of MIS-C through 20 September 2023. The PubMed/Medline, Web of Science, EMBASE, and Cochrane Library databases were searched with the combination of the terms “multisystem inflammatory syndrome”, “MIS-C”, “PIMS-TS”, “therapy”, “treatment”, “drug”, “IVIG”, “GCs”, “intravenous immunoglobulin”, “corticosteroids”, “biological agent”, and “aspirin”.

Results

The severity of MIS-C varies, and different treatment schemes should be used according to the specific condition. Ongoing research and data collection are vital to better understand the pathophysiology and optimal management of MIS-C.

Conclusions

MIS-C is a disease involving multiple systems and has great heterogeneity. With the accumulation of additional experience, we have garnered fresh insights into its treatment strategies. However, there remains a critical need for greater standardization in treatment protocols, alongside the pressing necessity for more robust and meticulously conducted studies to deepen our understanding of these protocols.

Video abstract

Supplementary file1 (MP4 208044 kb)

中文翻译：

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儿童多系统炎症综合征的治疗

背景

儿童多系统炎症综合征 (MIS-C) 是一种相对罕见但严重的儿科并发症，与 2019 年冠状病毒病 (COVID-19) 相关。多种治疗方法，包括静脉注射免疫球蛋白 (IVIG)、糖皮质激素 (GC) 和生物制剂，如阿那白滞素和英夫利昔单抗，已被描述用于治疗 COVID-19 相关的 MIS-C。抗凝治疗也很重要。然而，完善的治疗体系尚未建立，许多问题仍存在争议。最近发表的几篇与 MIS-C 治疗相关的文章已经发布。因此，在本综述中，我们梳理了近期发表的相关文章，对MIS-C的治疗进行了更全面、系统的总结。

数据源

我们回顾了截至 2023 年 9 月 20 日有关 MIS-C 治疗的文献。使用术语“多系统炎症综合征”、“MIS-C”组合检索了 PubMed/Medline、Web of Science、EMBASE 和 Cochrane 图书馆数据库。 、“PIMS-TS”、“疗法”、“治疗”、“药物”、“IVIG”、“GC”、“静脉注射免疫球蛋白”、“皮质类固醇”、“生物制剂”和“阿司匹林”。

结果

MIS-C的严重程度不同，应根据具体病情采用不同的治疗方案。持续的研究和数据收集对于更好地了解 MIS-C 的病理生理学和优化管理至关重要。

结论

MIS-C是一种涉及多个系统的疾病，具有很大的异质性。随着经验的积累，我们对其治疗策略有了新的见解。然而，仍然迫切需要提高治疗方案的标准化，同时迫切需要进行更强有力和细致的研究以加深我们对这些方案的理解。

视频摘要

补充文件1 (MP4 208044 kb)