Khoury Lana, Miller-Barmak Adi, Shehadeh Shereen, Cohen Hilla, Hadar Dana, Hamad Saied Mohamad
Department of Pediatrics, Carmel Medical Center, Haifa, Israel.
Pediatric Rheumatology Service, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel.
Front Pediatr. 2025 Jul 18;13:1607637. doi: 10.3389/fped.2025.1607637. eCollection 2025.
Multisystem Inflammatory Syndrome in Children (MIS-C) is a severe, life threatening, complication that arises weeks after acute Coronavirus disease 2019 (COVID-19) infection, often presenting with fever and diverse systemic symptoms. Limited data exists on the effectiveness of biologic and targeted-synthetic therapies in preventing MIS-C development. Therefore, our aim was to investigate whether biologic and targeted-synthetic therapies can prevent the occurrence of MIS-C.
We assessed the Clalit Health Services database, the largest health care organization in Israel, data from 793,909 children aged 0-18 years who tested positive for COVID-19 were analyzed. The diagnosis of MIS-C was adjudicated using the case definition used by the Centers for Disease Control and Prevention (CDC) or by the World Health Organization (WHO). Patients receiving biologic and targeted-synthetic therapies were compared to a control group.
Among 793,909 cases, 573 children received biologic and targeted-synthetic therapies, and 143 cases of MIS-C were identified. Notably, none of the individuals treated with biologic and targeted-synthetic therapies developed MIS-C.
Our study highlights our hypothesis on the efficacy of biological treatments in preventing MIS-C. Although statistical significance was not achieved due to the absence of MIS-C cases in patients receiving biologic and targeted-synthetic therapies, our study shows a possible association between biological therapies and reduced risk of MIS-C following COVID-19 infection in children. Further research, including prospective studies with larger cohorts, is warranted to confirm these findings and elucidate underlying mechanisms.
儿童多系统炎症综合征（MIS-C）是一种严重的、危及生命的并发症，在2019年冠状病毒病（COVID-19）急性感染数周后出现，常表现为发热和多种全身症状。关于生物制剂和靶向合成疗法在预防MIS-C发生方面的有效性的数据有限。因此，我们的目的是研究生物制剂和靶向合成疗法是否能预防MIS-C的发生。
我们评估了以色列最大的医疗保健机构Clalit Health Services数据库，分析了793,909名0至18岁COVID-19检测呈阳性儿童的数据。MIS-C的诊断根据美国疾病控制与预防中心（CDC）或世界卫生组织（WHO）使用的病例定义进行判定。将接受生物制剂和靶向合成疗法的患者与对照组进行比较。
在793,909例病例中，573名儿童接受了生物制剂和靶向合成疗法，共确诊143例MIS-C。值得注意的是，接受生物制剂和靶向合成疗法治疗的个体均未发生MIS-C。
我们的研究突出了我们关于生物治疗预防MIS-C疗效的假设。尽管由于接受生物制剂和靶向合成疗法的患者中没有MIS-C病例而未达到统计学显著性，但我们的研究表明生物疗法与儿童COVID-19感染后MIS-C风险降低之间可能存在关联。需要进一步的研究，包括更大队列的前瞻性研究，以证实这些发现并阐明潜在机制。
