Corticosteroids May Help Treat COVID-19 Complications in Children

A recent study conducted by investigators from Imperial College London has discovered that corticosteroids could potentially be an effective treatment for children who come to develop a rare but serious condition called pediatric inflammatory multi-system syndrome temporally associated with SARS-CoV-2 infection (PIMS-TS) after an infection with COVID-19.

Results from the study were published in the Journal of Medicine.

"The finding that outcome is similar for patients treated with steroids alone as with those treated with steroids and immunoglobulin or immunoglobulin alone, suggests that steroids may be a cheaper and more available alternative to immunoglobulin,” Elizabeth Whittaker, an author on the study said. “Corticosteroids are cheap and available worldwide whereas immunoglobulin is expensive, and there is a worldwide shortage of it. This is a particular problem in many low and middle income countries. "

For the study, the team of investigators looked at 2 treatments, a type of steroid called corticosteroids (such as methyl prednisolone) and an antibody treatment (called immunoglobulin). The study included 614 children, all of whom eventually developed PIMS-TS, and also involved hundreds of doctors from all over the world.

Findings from the study showed that all of the treatments quickly resolved inflammation 1 day quicker in comparison to those who did not receive the treatment. The levels of inflammation were measured by the level of a protein called C-reactive protein (CRP).

Levels of CRP were reduced by half, and there were no differences observed in rate of recovery from organ failure, or progression to organ failure between the treatments.

Additionally, when the analysis was restricted to those who met the World Health Organization's (WHO) criteria for MIS-C, lower rates of organ support or death at 2 days were seen in those receiving steroids alone.

"The study has been a real example of international collaboration and the willingness of pediatricians in many countries to share their data and experience to enable important questions as to optimal treatment to be answered,” Michael Levin, lead author on the study said. “Our finding, that treatments with immunoglobulin, steroids or a combination of both agents all result in more rapid resolution of inflammation (and have similar rates of progression to organ failure or recovery from critical illness), will be of great value to pediatricians worldwide in their treatment of children with this new disorder.”