{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,11]],"date-time":"2026-01-11T01:22:18Z","timestamp":1768094538655,"version":"3.49.0"},"reference-count":10,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,4,28]],"date-time":"2023-04-28T00:00:00Z","timestamp":1682640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>We describe approaches to steroid therapy use in paediatric multisystem inflammatory syndrome temporally associated with SARS\u2010CoV\u20102 (PIMS\u2010TS) and examine the association between steroid therapy and key clinical markers of severity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective review of children (&lt;18\u2009years) admitted to a tertiary paediatric hospital in the UK with PIMS\u2010TS. We collected data on if and why steroid therapy was used; the duration, type and dosing of steroids prescribed; and approaches to hypothalamo\u2010pituitary\u2010adrenal (HPA) axis monitoring, if performed. We examined associations between steroid exposure\/total steroid dose (mg\/m<jats:sup>2<\/jats:sup>\/day) and paediatric intensive care unit admission, mechanical ventilation and inotropic support.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Steroid therapy was commenced in most children (84.9%, <jats:italic>n<\/jats:italic>\u2009=\u2009104) with a median total daily steroid dose (hydrocortisone equivalent) of 271.0\u2009mg\/m<jats:sup>2<\/jats:sup>\/day (interquartile range 232.5\u2013355.5) and treatment length of 26.0\u2009days (interquartile range 19.0\u201332.0). Dosing regimens predominantly involved a short course of high\u2010dose methylprednisolone followed by tapering oral prednisolone. Basal and\/or dynamic testing of the HPA axis was conducted in a minority (11.8%, <jats:italic>n<\/jats:italic>\u2009=\u200915) and was normal. Duration of steroid therapy correlated positively with durations of paediatric intensive care unit admission (<jats:italic>r<\/jats:italic>\u2009=\u20090.407, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and mechanical ventilation (<jats:italic>r<\/jats:italic>\u2009=\u20090.797, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). A greater proportion of children receiving steroid therapy also received inotropic support compared to those that did not receive steroid therapy (71.4% vs. 45.5%, <jats:italic>P\u2009=<\/jats:italic>\u20090.025).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Prolonged, high\u2010dose steroid therapy is often used in the management of severe PIMS\u2010TS with the potential for HPA axis suppression and should be withdrawn carefully.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.16408","type":"journal-article","created":{"date-parts":[[2023,4,28]],"date-time":"2023-04-28T11:25:27Z","timestamp":1682681127000},"page":"890-894","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Characterising approaches to steroid therapy in paediatric multisystem inflammatory syndrome temporally associated with <scp>SARS\u2010CoV<\/scp>\u20102"],"prefix":"10.1111","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4289-0852","authenticated-orcid":false,"given":"Sin\u00e9ad M","family":"McGlacken\u2010Byrne","sequence":"first","affiliation":[{"name":"Department of Endocrinology Great Ormond Street Hospital  London United Kingdom"},{"name":"Genetics and Genomic Medicine, UCL Great Ormond Street Institute of Child Health University College London  London United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mae","family":"Johnson","sequence":"additional","affiliation":[{"name":"Paediatric Intensive Care Unit Great Ormond Street Hospital  London United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin","family":"Penner","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Great Ormond Street Hospital  London United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pascale","family":"du Pr\u00e9","sequence":"additional","affiliation":[{"name":"Paediatric Intensive Care Unit Great Ormond Street Hospital  London United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harshini","family":"Katugampola","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Great Ormond Street Hospital  London United Kingdom"},{"name":"Genetics and Genomic Medicine, UCL Great Ormond Street Institute of Child Health University College London  London United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,4,28]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-4642(20)30304-7"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-4642(20)30215-7"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.10369"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.050147"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-4642(21)00138-3"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2020.00574"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.41622"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61930-2"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2022-325156"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14963"}],"container-title":["Journal of Paediatrics and Child Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jpc.16408","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T12:58:11Z","timestamp":1692277091000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jpc.16408"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,28]]},"references-count":10,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2023,7]]}},"alternative-id":["10.1111\/jpc.16408"],"URL":"https:\/\/doi.org\/10.1111\/jpc.16408","archive":["Portico"],"relation":{},"ISSN":["1034-4810","1440-1754"],"issn-type":[{"value":"1034-4810","type":"print"},{"value":"1440-1754","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,28]]},"assertion":[{"value":"2022-10-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}