Immune globulin therapy – antibodies purified from donated blood and steroids could be the answer to COVID19 related multi-system inflammatory syndrome in children
Treatment with immunotherapy and steroids restored heart function in the majority of children with COVID-related multi-system inflammatory syndrome, according to a new research published in Circulation, the journal of the American Heart Association.
It has been recently noted that a small number of children exposed to COVID-19 develop an emergency condition involving inflammation in multiple systems of the body including inflammation in the heart. The symptoms most commonly observed are high-spiking fever, unusual lethargy over several days (asthenia), digestive signs including severe abdominal pain, vomiting or diarrhea, swollen lymph nodes (adenopathy) and skin rash.
In this study, researchers from France and Switzerland analyzed treatment outcomes for children admitted to the pediatric intensive care unit from March 22 to April 30, 2020, with fever, shock due to reduced functioning of the heart (or acute left ventricular dysfunction) with inflammatory state.
This analysis included 35 children (ages 2 to 16; median age of 10 years). Thirty-one (88.5%) children tested positive for SARS-CoV-2 infection, and none of the children had underlying cardiovascular disease. 17% of patients were overweight (n=6). All patients presented with fever and unusual lethargy (asthenia) lasting approximately 2 days, and 83% of patients (n=29) presented with upset stomach.
The majority of patients recovered within a few days following intravenous immune globulin, with added steroid therapy used in one third
Derangement of left ventricular systolic function was present in all patients in association with low blood pressure. Almost all patients required respiratory assistance (n= 33). Left ventricular function recovered in the majority of patients discharged from the intensive care unit (n=25). Ten patients treated with ECMO (extracorporeal membrane oxygenation) for 3-6 days were successfully weaned. (ECMO is a process whereby the blood is sent through a machine to increase the amount of oxygen in the blood. The oxygen-rich blood is then returned to the body.)
The majority of patients received intravenous immune globulin treatment (n=25), and 12 patients were treated with intravenous steroids. Three children were treated with an interleukin 1 receptor antagonist due to persistent severe inflammatory state. 23 patients were treated with a therapeutic dose of heparin. No deaths were observed.
“The majority of patients recovered within a few days following intravenous immune globulin, with added steroid therapy used in one third. Treatment with immune globulin appears to be associated with recovery of left ventricular systolic function,” researchers reported.
