kind of assessment until the next day , you ’ re likely already too late . We need to know immediately if the coronary is dilated so we can be very aggressive with treatment .”
IVIG therapy , or intravenous immunoglobulin therapy , is an anti-inflammatory medication that gives a patient the antibodies they need to fight an infection . It ’ s often used in patients with Kawasaki disease who , because of coronary artery dilation , are at increased risk of clotting and heart attack . MIS-C is the same in that respect , so delaying IVIG is dangerous . Depending on symptoms , coronary involvement and their severity , the multidisciplinary team may combine IVIG with a chimeric monoclonal antibody drug called infliximab .
They then monitor the patient throughout recovery , repeating labs and other steps in the protocol as necessary .
INFORMATION SHARING AND RESEARCH
Since May , the protocol has helped the multidisciplinary team successfully treat more than 14 patients who ’ ve been diagnosed with MIS-C . They continue to adjust for efficiency , removing excess labs as they learn more . The comprehensive protocol is so effective , in fact , that institutions across the country have asked for it , and Children ’ s Colorado readily provides the information .
Boston Children ’ s Hospital also took note of the protocol and asked Children ’ s Colorado to join a study called Long- Term Outcomes after the Multisystem Inflammatory Syndrome In Children that looks at heart function and long-term outcomes of MIS-C patients .
Children ’ s Colorado is participating in several other research initiatives related to MIS-C and COVID-19 . One is with Rady Children ’ s Hospital called Characterization of Multisystem Inflammatory Syndrome in Children ( CHARMS ) and its relationship to Kawasaki disease . That study will compare blood work in KD and MIS-C patients for biomarker differences . The other is a multi-center study funded by the National Institutes of Health called Overcoming COVID-19 .
Additionally , Dr . Jone is in the process of writing a guideline paper for the American Heart Association on COVID-19 and the cardiovascular complications in pediatric congenital heart disease patients . She and the paper ’ s other authors hope to publish in the next three months .
“ We are fortunate to have such a robust group of providers that have studied Kawasaki disease and management for quite some time , and I think that gave us an advantage in responding to this newly emerging disease ,” says Dr . Osborne . •
In addition to helping develop comprehensive and effective guidelines for treating MIS-C , pediatric cardiologist Pei-Ni Jone , MD , is working to better understand the condition and why it presents similarly to Kawasaki disease .
Clinical Improvement Team
Leigh Anne Bakel , MD , Hospital Medicine ; Juri Boguniewicz , MD , Infectious Disease ; Todd Carpenter , MD , PICU ; Donna Curtis , MD , Infectious Disease ; Sam Dominguez , MD , Infectious Disesase ; Robert Fuhlbrigge , MD , PhD , Rheumatology ; Joseph Grubenhoff , MD , Emergency Medicine ; Pei-Ni Jone , MD , Cardiology ; Justin Lockwood , MD , Hospital Medicine ; Aline Maddux , MD , PICU ; Jean Mulcahy Levy , MD , Oncology ; Eva Nozik , MD , PICU ; Kaleigh Ogawa , RN , Clinical Effectiveness ; Christina Osborne , MD , ID Fellow ; Suchitra Rao , MBBS , MSCS , Infectious Disease ; Marion Sills , MD , Emergency Medicine ; Irina Topoz , MD , Emergency Medicine
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