“…Due to a lack of data, we did not include repeated IVIG resistance in our analysis. Of the 27 studies, 21 studies [ 9 – 13 , 19 , 21 , 23 – 25 , 28 , 29 , 31 – 33 , 35 – 40 ] including 36,499 participants reported initial IVIG resistance, and 5764 had IVIG resistance (15.8%). Very low-quality evidence showed that, using day 4 of fever as the cut-off point, the early group ( ≦ 4 days) had a higher initial IVIG-resistance (RR, 1.80; 95% CI, 1.50–2.15; P < .00001; I 2 = 75%) than the late group (>4 days), with 21.6% (2699 of 12,481) in the early group VS 12.2% (2720 of 22,277) in the late group (Fig.…”