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. 2024 Aug 21;24(1):847.
doi: 10.1186/s12879-024-09581-w.

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

Muhammed Shabil #  1   2 , Mahalaqua Nazli Khatib #  3 , Godfrey T Banda  4 , Quazi Syed Zahiruddin  5 , Suhas Ballal  6 , Pooja Bansal  7 , Manish Srivastava  8 , Isha Arora  9 , M Ravi Kumar  10 , Aashna Sinha  11 , Kumud Pant  12   13 , Jumana M Al-Jishi  14 , Hawra Albayat  15 , Mona A Al Fares  16 , Mohammed Garout  17 , Hayam A Alrasheed  18 , Maha F Al-Subaie  19   20 , Ali A Rabaan  19   21   22
Affiliations

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

Muhammed Shabil et al. BMC Infect Dis. .

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.

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.

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.

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.

Keywords: Anakinra; COVID-19; Good health and well-being; Multisystem inflammatory syndrome in children; Systematic review.

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Conflict of interest statement

The authors declare no competing interests.

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PRISMA flowchart depicting article screening and study selection process
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References

    1. Feldstein LR, Tenforde MW, Friedman KG, Newhams M, Rose EB, Dapul H, et al. Characteristics and outcomes of US children and adolescents with multisystem inflammatory syndrome in children (MIS-C) compared with severe acute COVID-19. JAMA. 2021;325(11):1074–87. - PMC - PubMed
    1. Radia T, Williams N, Agrawal P, Harman K, Weale J, Cook J, Gupta A. Multi-system inflammatory syndrome in children & adolescents (MIS-C): a systematic review of clinical features and presentation. Paediatr Respir Rev. 2021;38:51–7. - PMC - PubMed
    1. Hejazi OI, Loke Y-H, Harahsheh AS. Short-term cardiovascular complications of multi-system inflammatory syndrome in children (MIS-C) in adolescents and children. Curr Pediatr Rep. 2021:1–11. - PMC - PubMed
    1. Wu EY, Campbell MJ. Cardiac manifestations of multisystem inflammatory syndrome in children (MIS-C) following COVID-19. Curr Cardiol Rep. 2021;23:1–9. - PMC - PubMed
    1. Kumar V, Soni M, Dutt M. Assessing the incidence of myocarditis risk in mRNA COVID-19 vaccines: a systematic review and meta-analysis. Evid. 2024;2(1).

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