EFFECTIVENESS OF IVIG AND PULSE METHYLPREDNISOLONE IN TREATING MULTISYSTEM INFLAMMATORY SYNDROME IN CHILDREN (MIS-C) ASSOCIATED WITH COVID-19: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), has emerged as a global health concern, leading to significant morbidity and mortality. Post-COVID-19, children have exhibited an increased susceptibility to multisystem inflammatory syndrome (MIS-C). Treatment for MIS-C involved the administration of intravenous immunoglobulin (IVIG) alone or in conjunction with pulse methylprednisolone. For patients with persistent fever, a second-line treatment approach, comprising additional doses of IVIG and methylprednisolone, was considered. A systematic review and meta-analysis were conducted to assess the statistical significance of treatment outcomes. The review included five studies, demonstrating similar efficacy between the two treatment modalities for MIS-C patients. However, the determination of primary outcomes and the need for second-line treatment depended on various clinical factors. The studies exhibited a low risk of bias, and the meta-analysis showed statistical significance with a difference of 0.66 [95% CI, 0.30 to 1.44; p= <0.01] in treatment effectiveness between the two groups. This study provides clinicians with a prompt treatment option and contributes to the enhancement of treatment strategies for MIS-C patients.