Vukomanovic, Vladislav (55881072000)Vladislav (55881072000)VukomanovicKrasic, Stasa (57192096021)Stasa (57192096021)KrasicPrijic, Sergej (20734985500)Sergej (20734985500)PrijicNinic, Sanja (51864038300)Sanja (51864038300)NinicPopovic, Sasa (57200324005)Sasa (57200324005)PopovicPetrovic, Gordana (57211071996)Gordana (57211071996)PetrovicRistic, Snezana (57213555181)Snezana (57213555181)RisticSimic, Radoje (16744648200)Radoje (16744648200)SimicCerovic, Ivana (57220213990)Ivana (57220213990)CerovicNesic, Dejan (26023585700)Dejan (26023585700)Nesic2025-06-122025-06-122021https://doi.org/10.1097/INF.0000000000003260https://www.scopus.com/inward/record.uri?eid=2-s2.0-85117778964&doi=10.1097%2fINF.0000000000003260&partnerID=40&md5=76e74e2324f87811da233c5f6c65f93ahttps://remedy.med.bg.ac.rs/handle/123456789/3977Background: Cardiovascular complications with myocarditis in multisystem inflammatory syndrome in children (MIS-C) associated with severe acute respiratory syndrome coronavirus 2 infection have been reported, but the optimal therapeutic strategy remains unknown. Methods: A retrospective cohort study included 19 patients with acute left ventricular systolic dysfunction associated with MIS-C, average years of age 13.2 ± 3.8, treated from April 2020 to April 2021. Results: Treatment failure (TF) was observed in 8 patients (in the intravenous immunoglobulin [IVIG] group 7/10; in the corticosteroid [CS] group 1/9). The independent risk factor for TF was IVIG treatment (odds ratio [OR] 18.6, 95% confidence interval [CI] 1.6-222.93, P = 0.02). Patients initially treated with CS became afebrile during in-hospital day 1 (1.5, interquartile range [IQR] 1-2), while IVIG-treated patients became afebrile on in-hospital day 4 (IQR 2-4.25), after CS was added. The C-reactive protein (CRP) significantly declined in CS-treated patients on day 2 (P = 0.01), while in the IVIG group, CRP decreased significantly on the fourth day (P = 0.04). Sodium and albumin levels were higher on third in-hospital day in the CS group than in the IVIG group (P = 0.015, P = 0.03). A significant improvement and normalization of ejection fraction (EF) during the first 3 days was observed only in the CS group (P = 0.005). ICU stays were shorter in the CS group (4, IQR 2-5.5) than in the IVIG group (IVIG group 7, IQR 6-8.5) (P = 0.002). Conclusions: Among children with MIS-C with cardiovascular involvement, treatment with CS was associated with faster normalization of LV EF, fever, laboratory analysis, and shorter ICU than IVIG-treated patients. © 2021 Lippincott Williams and Wilkins. All rights reserved.corticosteroidsimmunoglobulinsmyocardial injurypediatric multisystem inflammatory syndromesevere acute respiratory syndrome coronavirus 2