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Sugunan S, Bindusha S, Niyas HR, Geetha S, Chinchilu RV. Factors Associated with Pulse Methylprednisolone Treatment Failure in COVID-19-Related Multisystem Inflammatory Syndrome in Children (MIS-C). J PEDIAT INF DIS-GER 2022. [DOI: 10.1055/s-0042-1755210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Abstract
Objective This article determines the occurrence and variables associated with pulse methylprednisolone treatment failure in children with coronavirus disease 2019 (COVID-19)-related multisystem inflammatory syndrome in children (MIS-C).
Methods This prospective observational study was undertaken at a tertiary care teaching hospital in Kerala, India. Children admitted with COVID-19-related MIS-C who were treated with pulse methylprednisolone as first-line therapy were included in the study. Depending on the response to the treatment, they were divided into two groups. The clinical, laboratory parameters, and follow-up findings at 3 months were compared between the two groups
Results Seventy-six patients were admitted with MIS-C during the study period. Sixty received pulse methylprednisolone as the first-line therapy. Of the 60 patients who received pulse methylprednisolone, 50 responded to treatment, while 10 required repeat immunomodulation. Need for noninvasive or invasive ventilation (relative risk [RR]: 13.14, 95% confidence interval [CI]: 3.147–54.88), six or more organ involvement (RR: 4.667, 95% CI: 1.349–16.149), thrombocytopenia (RR: 6.43, 95% CI: 0.87–47.6, p 0.003), and abnormal chest X-ray findings at admission (RR: 4.5, 95% CI: 1.46–13.8), were found to be associated with increased risk of treatment failure with pulse methylprednisolone therapy. Note that 88% of patients with coronary artery involvement showed resolution at 3-month follow-up.
Conclusion More than 80% of children with MIS-C can be treated successfully with corticosteroids. The need for ventilator support, abnormal chest X-ray findings, and thrombocytopenia at admission were found to be factors associated with pulse methylprednisolone treatment failure.
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Affiliation(s)
- Sheeja Sugunan
- Department of Paediatrics, Government Medical College Thiruvananthapuram, Thiruvananthapuram, Kerala, India
| | - S. Bindusha
- SAT Hospital, Government Medical College, Thiruvananthapuram, Kerala, India
| | - H. R. Niyas
- SAT Hospital, Government Medical College, Thiruvananthapuram, Kerala, India
| | - S. Geetha
- SAT Hospital, Government Medical College, Thiruvananthapuram, Kerala, India
| | - R V Chinchilu
- SAT Hospital, Government Medical College, Thiruvananthapuram, Kerala, India
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Sugunan S, Bindusha S, Geetha S, Niyas HR, Kumar AS. Clinical Profile and Short-Term Outcome of Children With SARS-CoV-2 Related Multisystem Inflammatory Syndrome (MIS-C) Treated With Pulse Methylprednisolone. Indian Pediatr 2021. [PMID: 33876782 PMCID: PMC8384095 DOI: 10.1007/s13312-021-2277-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objective Method Results Conclusion
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Affiliation(s)
- Sheeja Sugunan
- Department of Pediatrics, SAT Hospital, Government Medical College, Thiruvananthapuram, Kerala. Correspondence to: Dr Sheeja Sugunan, Associate Professor, Department of Pediatrics, SAT hospital, Government Medical College Thiruvananthapuram, Kerala.
| | - S Bindusha
- Department of Pediatrics, SAT Hospital, Government Medical College, Thiruvananthapuram, Kerala
| | - S Geetha
- Department of Pediatrics, SAT Hospital, Government Medical College, Thiruvananthapuram, Kerala
| | - H R Niyas
- Department of Pediatrics, SAT Hospital, Government Medical College, Thiruvananthapuram, Kerala
| | - A Santhosh Kumar
- Department of Pediatrics, SAT Hospital, Government Medical College, Thiruvananthapuram, Kerala
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Iype M, Sreedharan M, Ahamed S, Thomas E, Eapen M, Sugunan S, Saradakutty G, Bindusha S. Dravet syndrome Presenting with Extrapyramidal Features, Ataxia and Basal Ganglia Hyperintensity on Brain Magnetic Resonance Imaging. Ann Indian Acad Neurol 2021; 24:839-841. [PMID: 35002176 PMCID: PMC8680914 DOI: 10.4103/aian.aian_1216_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/14/2020] [Accepted: 01/02/2021] [Indexed: 11/22/2022] Open
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Bindusha S, Nair S, Beegum MS. Glycosylated hemoglobin levels and lipid profile in children with asthma using low dose and high dose inhaled corticosteroids. Indian J Allergy Asthma Immunol 2015. [DOI: 10.4103/0972-6691.162977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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