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Effectiveness of early Anakinra on cardiac function in children with multisystem inflammatory syndrome of COVID-19: a systematic review.

Effectiveness of early Anakinra on cardiac function in children with multisystem inflammatory syndrome of COVID-19: a systematic review.

Authors :
Shabil M
Khatib MN
Banda GT
Zahiruddin QS
Ballal S
Bansal P
Srivastava M
Arora I
Kumar MR
Sinha A
Pant K
Al-Jishi JM
Albayat H
Al Fares MA
Garout M
Alrasheed HA
Al-Subaie MF
Rabaan AA
Source :
BMC infectious diseases [BMC Infect Dis] 2024 Aug 21; Vol. 24 (1), pp. 847. Date of Electronic Publication: 2024 Aug 21.
Publication Year :
2024

Abstract

Background: Multisystem Inflammatory Syndrome in Children (MIS-C) associated with SARS-CoV-2 can lead to severe cardiovascular complications. Anakinra, an interleukin-1 receptor antagonist, is proposed to benefit the hyperinflammatory state of MIS-C, potentially improving cardiac function. This systematic review evaluated the effectiveness of early Anakinra administration on cardiac outcomes in children with MIS-C.<br />Methods: A comprehensive search across PubMed, Embase, and Web of Science until March 2024 identified studies using Anakinra to treat MIS-C with reported cardiac outcomes. Observational cohorts and clinical trials were included, with data extraction focusing on cardiac function metrics and inflammatory markers. Study quality was assessed using the Newcastle-Ottawa Scale.<br />Results: Six studies met the inclusion criteria, ranging from retrospective cohorts to prospective clinical studies, predominantly from the USA. Anakinra dosages ranged from 2.3 to 10 mg/kg based on disease severity. Several studies showed significant improvements in left ventricular ejection fraction and reductions in inflammatory markers like C-reactive protein, suggesting Anakinra's role in enhancing cardiac function and mitigating inflammation. However, findings on vasoactive support needs were mixed, and some studies did not report significant changes in acute cardiac support requirements.<br />Conclusion: Early Anakinra administration shows potential for improving cardiac function and reducing inflammation in children with MIS-C, particularly those with severe manifestations. However, the existing evidence is limited by the observational nature of most studies and lacks randomized controlled trials (RCTs). Further high-quality RCTs are necessary to conclusively determine Anakinra's effectiveness and optimize its use in MIS-C management for better long-term cardiac outcomes and standardized treatment protocols.<br /> (© 2024. The Author(s).)

Details

Language :
English
ISSN :
1471-2334
Volume :
24
Issue :
1
Database :
MEDLINE
Journal :
BMC infectious diseases
Publication Type :
Academic Journal
Accession number :
39169304
Full Text :
https://doi.org/10.1186/s12879-024-09581-w