Children admitted to the PICU and/or suffering from hypotension were more likely to receive a combination of corticosteroids and IVIG. study comprised 91 patients who were diagnosed with MIS-C and were under the age of 18. 42 (46.2%) of these patients were in the IVIG alone group (group I), and 49 (53.8%) were in the IVIG?+?methylprednisolone group (group Droxidopa II). Patients in group II experienced a severe MIS-C ratio of 36.7%, which was substantially greater than the rate of severe MIS-C patients in group I (9.5%) (p 0.01). When compared to group I (9.5%), the rate of hypotension was considerably higher in group II (30.6%) (valueNot applicable, Pediatric Intensive Care Unit Treatment modalities of the MIS-C The initial treatment was intravenous immunoglobulin alone at 42 patients (46.2%) and intravenous immunoglobulin plus methylprednisolone was administered at 49 patients (53.8%). Eighteen patients (19.8%) required inotropic brokers and 14 patients (15.4%) required respiratory support including high-flow nasal cannula. Of 91 patients, 22 (24.2%) were followed up in the pediatric intensive care unit (PICU). During follow-up, no mortality was observed in our study cohort. What effect the decision for an initial steroid to IVIG at MIS-C period of fever and time to start IVIG The median age of group II patients was significantly older than that of group I patients (96?months, 5 to 168?months vs 51?months, 16 to 204; valueAbsolute lymphocyte count, Absolute neutrophil count, C-reactive protein, Erythrocyte sedimentation rate, Platelet count, White blood cell count The prognosis and the treatment of choice The recurrence of fever was 26.5% (n?=?13) in group II and 33.3% (n?=?14) in group I, although there was no statistically significant difference (p?n?=?7) in group II and 9.5% (n?=?4) in group I; however, there was no statistically significant difference between the groups (p?>?0.05). The mean Droxidopa hospitalization period was 9.9??1.2?days (2 to 55?days in the group I and 10.4??0.6?days (4 to 20?days) in the group II and no significant difference was present between these two groups (p?>?0.05). Discussion In this study, we discussed our experience with MIS-C in children and the outcomes of patients treated with IVIG alone or in Droxidopa conjunction with corticosteroids. In 46.2% of 91 patients, intravenous immunoglobulin was supplied alone, whereas intravenous immunoglobulin plus steroid was administered in 53.8% of patients. Children admitted to the PICU and/or suffering from hypotension were more likely to receive a combination of corticosteroids and IVIG. We discovered no statistically significant difference between the effects of two treatment strategies on the length of hospital stay and recovery from fever when we compared their effects on the outcome. According to systemic reviews conducted at the onset of the pandemic, IVIG was the most often employed treatment modality, with a rate of 76.4% among 662 patients, followed by corticosteroids and other medications, including corticosteroids, with a rate of 52.3%?[23]. However, towards the end of a 12 months of the COVID-19 pandemic, the combination of IVIG and steroids has been incorporated into the main treatment protocols [24]. A recent retrospective analysis including 181 MIS-C patients that examined the response of IVIG alone and in conjunction with steroid treatment methods revealed that the use of IVIG in combination with steroid treatment is usually associated with a more positive end result [24]. While the rate of failure to respond in terms of fever was % in the IVIG and methylprednisolone group and 51%?in the IVIG group, the failure rate?was much higher in the IVIG group [23]. Similarly, in a different study, Belhadjer et al. found that IVIG?+?steroids was related with a quicker cardiac recovery in patients with MIS-C [15]. In the early stages of the COVID-19 pandemic, the United Kingdom recommendations advocated the use of IVIG alone [18], but more recent papers favored the first combination of IVIG and corticosteroids [15, 24]. In addition, according to a recent study by Ouldali et al., among the 72 patients with MIS-C in the IVIG-alone treatment group, corticosteroids were added to the treatment regimen for only 13 patients (18.1%) [24]. In patients with LIPO MIS-C, the decision to add a steroid to the IVIG upon admission is not governed by specific criteria. In two individual Turkish investigations, Ozsurekci et al. and Alkan et al. found that all patients received a high dose of IVIG and corticosteroids concurrently [25, 26]. Indications for initial IVIG and steroid mixture had been linked to the scientific intensity of the individual mainly, such as frustrated EF, existence of hypotension, and/or respiratory insufficiencies, that have been primarily contained in the criteria for severe and moderate MIS-C diagnosis [19]. In our evaluation,.