Evidence map›Paper›PMID 36367723›Full record

ArticleJAMA network open2022

Postdischarge Glucocorticoid Use and Clinical Outcomes of Multisystem Inflammatory Syndrome in Children.

Mary Beth F Son, Laura Berbert, Cameron Young, Johnathan Dallas, Margaret Newhams, Sabrina Chen, Stacy P Ardoin, Matthew L Basiaga, Susan P Canny, Hillary Crandall and 21 more

Open access · goldAbstract readMulticenter Study
In one paragraph

Article in JAMA network open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
2.2field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

31 authors at 15 institutions in 1 country.

Mary Beth F SonDivision of Immunology, Boston Children's Hospital, Boston, Massachusetts.
Laura BerbertInstitute Centers for Clinical and Translational Research, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
Cameron YoungDepartment of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts.
Johnathan DallasDivision of Immunology, Boston Children's Hospital, Boston, Massachusetts.
Margaret NewhamsDepartment of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts.
Sabrina ChenDepartment of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts.
Stacy P ArdoinRheumatology, Nationwide Children's Hospital, Department of Pediatrics, Ohio State College of Medicine, Columbus.
Matthew L BasiagaDivision of Pediatric Rheumatology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota.
Susan P CannyDivision of Pediatric Rheumatology, Seattle Children's Hospital, Department of Pediatrics, University of Washington, Seattle.
Hillary CrandallDivision of Pediatric Critical Care, Department of Pediatrics, University of Utah, Primary Children's Hospital, Salt Lake City.
Sanjeev DhakalDivision of Rheumatology, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.
Anita DhanrajaniPediatric Rheumatology, Department of Pediatrics, University of Mississippi Medical Center, Jackson.
Anna Carmela P Sagcal-GironellaDepartment of Pediatrics, Hackensack Meridian School of Medicine, Hackensack, New Jersey.
Charlotte V HobbsDivision of Pediatric Infectious Disease, Department of Pediatrics, University of Mississippi Medical Center, Jackson.
Livie HuieDivision of Pediatric Rheumatology, University of Alabama at Birmingham.
Karen JamesDivision of Pediatric Rheumatology, Department of Pediatrics, University of Utah, Primary Children's Hospital, Salt Lake City.
Madelyn JonesRheumatology, Nationwide Children's Hospital, Department of Pediatrics, Ohio State College of Medicine, Columbus.
Susan KimPediatric Rheumatology, UCSF Benioff Children's Hospital, Department of Pediatrics, University of California at San Francisco School of Medicine.
Geraldina LionettiPediatric Rheumatology, UCSF Benioff Children's Hospital, Department of Pediatrics, University of California at San Francisco School of Medicine.
Melissa L MannionDivision of Pediatric Rheumatology, University of Alabama at Birmingham.
Eyal MuscalDivision of Rheumatology, Texas Children's Hospital, Department of Pediatrics, Baylor School of Medicine, Houston.
Sampath PrahaladChildren's Healthcare of Atlanta, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.
Grant S SchulertDivision of Rheumatology, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.
Kristen Sexson TejtelDivision of Cardiology, Texas Children's Hospital, Department of Pediatrics, Baylor School of Medicine, Houston.
D Sofia Villacis-NunezChildren's Healthcare of Atlanta, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.
Eveline Y WuDivision of Pediatric Rheumatology, UNC Children's Hospital, Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill.
Laura D ZambranoCOVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia.
Angela P CampbellCOVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia.
Manish M PatelCOVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia.
Adrienne G RandolphDepartment of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts.
Overcoming COVID-19 Investigators
Boston Children's Hospital · USCenters for Disease Control and Prevention · USBaylor School · USCincinnati Children's Hospital Medical Center · USEmory University · USNationwide Children's Hospital · USPrimary Children's Hospital · USUCSF Benioff Children's Hospital · USUniversity of Alabama at Birmingham · USJackson Memorial Hospital · USMayo Clinic in Florida · USSeattle Children's Hospital · USSt. Joseph’s Children’s Hospital · USUniversity of Mississippi Medical Center · USUniversity of North Carolina Health Care · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Importance: Minimal data are available regarding the postdischarge treatment of multisystem inflammatory syndrome in children (MIS-C). Objectives: To evaluate clinical characteristics associated with duration of postdischarge glucocorticoid use and assess postdischarge clinical course, laboratory test result trajectories, and adverse events in a multicenter cohort with MIS-C. Design, Setting, and Participants: This retrospective cohort study included patients with MIS-C hospitalized with severe illness and followed up for 3 months in an ambulatory setting. Patients younger than 21 years who were admitted between May 15, 2020, and May 31, 2021, at 13 US hospitals were included. Inclusion criteria were inpatient treatment comprising intravenous immunoglobulin, diagnosis of cardiovascular dysfunction (vasopressor requirement or left ventricular ejection fraction ≤55%), and availability of complete outpatient data for 3 months. Exposures: Glucocorticoid treatment. Main Outcomes and Measures: Main outcomes were patient characteristics associated with postdischarge glucocorticoid treatment, laboratory test result trajectories, and adverse events. Multivariable regression was used to evaluate factors associated with postdischarge weight gain (≥2 kg in 3 months) and hyperglycemia during illness. Results: Among 186 patients, the median age was 10.4 years (IQR, 6.7-14.2 years); most were male (107 [57.5%]), Black non-Hispanic (60 [32.3%]), and Hispanic or Latino (59 [31.7%]). Most children were critically ill (intensive care unit admission, 163 [87.6%]; vasopressor receipt, 134 [72.0%]) and received inpatient glucocorticoid treatment (178 [95.7%]). Most were discharged with continued glucocorticoid treatment (173 [93.0%]); median discharge dose was 42 mg/d (IQR, 30-60 mg/d) or 1.1 mg/kg/d (IQR, 0.7-1.7 mg/kg/d). Inpatient severity of illness was not associated with duration of postdischarge glucocorticoid treatment. Outpatient treatment duration varied (median, 23 days; IQR, 15-32 days). Time to normalization of C-reactive protein and ferritin levels was similar for glucocorticoid duration of less than 3 weeks vs 3 or more weeks. Readmission occurred in 7 patients (3.8%); none was for cardiovascular dysfunction. Hyperglycemia developed in 14 patients (8.1%). Seventy-five patients (43%) gained 2 kg or more after discharge (median 4.1 kg; IQR, 3.0-6.0 kg). Inpatient high-dose intravenous and oral glucocorticoid therapy was associated with postdischarge weight gain (adjusted odds ratio, 6.91; 95% CI, 1.92-24.91). Conclusions and Relevance: In this multicenter cohort of patients with MIS-C and cardiovascular dysfunction, postdischarge glucocorticoid treatment was often prolonged, but clinical outcomes were similar in patients prescribed shorter courses. Outpatient weight gain was common. Readmission was infrequent, with none for cardiovascular dysfunction. These findings suggest that strategies are needed to optimize postdischarge glucocorticoid courses for patients with MIS-C.

Indexed as

HyperglycemiaPneumonia, ViralAftercareChildCOVID-19FemaleGlucocorticoidsHumansMalePandemicsPatient DischargeRetrospective StudiesStroke VolumeSystemic Inflammatory Response SyndromeVentricular Function, LeftWeight GainGlucocorticoids

Identifiers

PMID36367723
PMCPMC9652757
OpenAlexW4308796736

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.