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Villena R, Izquierdo G, Wilhelm J, García C, Acuña M, Riquelme P, Alvarado S, Torres JP. Dynamics of multisystem inflammatory syndrome in children associated to COVID-19 in Chile: Epidemiologic trends during pandemic, before and after children vaccination. Vaccine 2024; 42:126015. [PMID: 38852034 DOI: 10.1016/j.vaccine.2024.05.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 05/27/2024] [Accepted: 05/28/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Multisystem inflammatory syndrome associated to Covid-19 (MIS-C) is one of the most severe outcomes of SARS-CoV-2 in children. Covid-19 vaccines were successfully implemented in Chile for the pediatric population since 2021, using both mRNA and inactivated platforms. Effectiveness against MIS-C has been reported for mRNA vaccines. The aim of this study was to describe the epidemiologic trend of MIS-C in Chile during Covid-19 pandemic, both before and after the availability of vaccination for children. MATERIALS AND METHODS Analytic study of MIS-C cases from April 2020 to December 2022. Epidemiological data, SARS-CoV-2 variants and vaccination uptake information were obtained from the Epidemiology Department-Ministry of Health, Institute of Public Health and the National Immunization Program, respectively. RESULTS 496 cases of MIS-C were reported, 58 % males. Median age was 5 years and most frequent age-cohorts were 6-11 and 0-2 years old with a 33 % each. After the introduction of the Covid-19 vaccine, most cases occurred in children aged 0-2 years. Incidence rates were 3.8, 5.4 and 1.7 per 100,000 inhabitants in 2020, 2021 and 2022, respectively. 97 % of cases (481) occurred in unvaccinated subjects. On those previously vaccinated (15), all but one case occurred in children receiving the inactivated vaccine. No association among circulating variants and incidence was observed. Incidence rate reduction (IRR) comparison between 2020 and 2021-2022 periods was 0.72 (CI 95 % 0.65-0.81, p < 0.05) overall; 0.86 for 0-2 years (CI 95 %:0.71-1; p = 0.12); 0.88 for 3-5 years (CI 95 %:0.69-1.11; p = 0.28); 0.61 for 6-11 years (CI 95 %: 0.50-0.75; p < 0.05); and 0.64 for 12-17 years (CI 95 %:0.47-0.89; p < 0.05), consistent with vaccination uptake during the studied period: 63 % for 3-5 years, 91 % for 6-11 years, and 99 % for 12-17 years. CONCLUSIONS A decline of MIS-C incidence and a shift to younger, unvaccinated population overtime was observed. IRR decreased in age-cohorts which achieved high vaccination rates.
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Affiliation(s)
- R Villena
- Faculty of Medicine, Universidad de Chile, Chile; Department of Pediatrics, Hospital de niños Dr. Exequiel González Cortés, Chile.
| | - G Izquierdo
- Faculty of Medicine, Universidad de Chile, Chile; Department of Pediatrics, Hospital de niños Dr. Exequiel González Cortés, Chile
| | - J Wilhelm
- Department of Pediatrics, Hospital de niños Dr. Luis Calvo Mackenna, Chile
| | - C García
- Epidemiology Department, Ministry of Health, Chile
| | - M Acuña
- Regional ministry secretariat, Under-Secretary for Public Health, Chile
| | - P Riquelme
- Regional ministry secretariat, Under-Secretary for Public Health, Chile
| | - S Alvarado
- Epidemiology Department, Ministry of Health, Chile
| | - J P Torres
- Faculty of Medicine, Universidad de Chile, Chile; Department of Pediatrics, Hospital de niños Dr. Luis Calvo Mackenna, Chile
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Solito C, Hernández-García M, Arguedas Casamayor N, Pavón Ortiz A, Pino R, Alsina L, F de Sevilla M. COVID-19 admissions: Trying to define the real impact of infection in hospitalized patients. An Pediatr (Barc) 2024; 100:342-351. [PMID: 38580601 DOI: 10.1016/j.anpede.2024.03.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/08/2024] [Indexed: 04/07/2024] Open
Abstract
INTRODUCTION AND OBJECTIVE Several studies have suggested that the hospitalization rate for COVID-19 in children and adolescents may reflect the prevalence of the infection rather than the severity of the disease. The aim of this study was to describe the clinical features of hospitalised paediatric patients with SARS-CoV-2 infection in order to understand if the infection was the reason for admission. METHODS Retrospective cohort study including patients aged 0-18 years with SARS-CoV-2 infection or multisystem inflammatory syndrome in children (MIS-C) admitted to a tertiary care children's hospital in Spain between 01/01/2020 and 12/31/2021. RESULTS 228 patients were included, corresponding to 150 cases of COVID-related admission (SARS-CoV-2 infection as main cause of hospitalization) and 78 of non-COVID-related admission (SARS-CoV-2 infection unrelated to the hospitalization). In the group of COVID-related admissions, 58 patients had comorbidities. Forty-nine patients had acute respiratory disease (pneumonia, bronchospasm or bronchiolitis). Multisystem inflammatory syndrome in children was diagnosed in 27 and was significantly more frequent in the first year of the pandemic (wild type virus). Eighty percent of patients with acute respiratory disease needed respiratory support, mostly low-flow oxygen therapy. The severity of the disease was similar in all virus variants. Two patients (both with severe comorbidities) died from COVID-related conditions. CONCLUSIONS In our study, one third of the patients were admitted with SARS-CoV-2 infection but not because of it. Acute respiratory disease was less frequent and had a better prognosis compared to the adult population, while MIS-C was a major cause of morbidity and hospitalization. The fatality rate was extremely low.
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Affiliation(s)
- Claudia Solito
- Servicio de Pediatría, Hospital Sant Joan de Déu Barcelona, Barcelona, Spain
| | - María Hernández-García
- Servicio de Pediatría, Hospital Sant Joan de Déu Barcelona, Barcelona, Spain; Grupo de Estudio de Enfermedades Infecciosas y Microbioma, Institut de Recerca Sant Joan de Déu (IRSJD), Barcelona, Spain.
| | | | - Alba Pavón Ortiz
- Servicio de Pediatría, Hospital Sant Joan de Déu Barcelona, Barcelona, Spain
| | - Rosa Pino
- Servicio de Pediatría, Hospital Sant Joan de Déu Barcelona, Barcelona, Spain
| | - Laia Alsina
- Grupo de Estudio de Enfermedades por Disfunción Inmune en Pediatría, Institut de Recerca Sant Joan de Déu (IRSJD), Barcelona, Spain; Unidad de Inmunología Clínica e Inmunodeficiencias Primarias, Servicio de Alergia e Inmunología Clínica, Hospital Sant Joan de Déu Barcelona, Barcelona, Spain; Facultad de Medicina y Ciencias de la Salud, Universitat de Barcelona, Barcelona, Spain; Programa de Inmunología Clínica, Hospital Sant Joan de Déu-Hospital Clínic Barcelona, Barcelona, Spain; Plataforma de Terapias Avanzadas, Hospital Sant Joan de Déu-Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Mariona F de Sevilla
- Servicio de Pediatría, Hospital Sant Joan de Déu Barcelona, Barcelona, Spain; Grupo de Estudio de Enfermedades Infecciosas y Microbioma, Institut de Recerca Sant Joan de Déu (IRSJD), Barcelona, Spain; Facultad de Medicina y Ciencias de la Salud, Universitat de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), Instituto de Salud Carlos III, Madrid, Spain
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Lampidi S, Maritsi D, Charakida M, Eleftheriou I, Farmaki E, Spyridis N, Charisi K, Vantsi P, Filippatos F, Skourti K, Papadopoulou-Alataki E, Papadopoulou-Legbelou K, Kampouridou P, Grivea IN, Vergadi E, Gkentzi D, Dimou D, Koletsi P, Fotis L, Liakopoulou T, Agrafiotou A, Kourtesi K, Tsolas G, Kafetzis D, Papaevangelou V, Dimitriou G, Galanakis E, Syrogiannopoulos GA, Spoulou V, Michos A, Roilides E, Tsolia MN. Multisystem inflammatory syndrome in children (MIS-C): A nationwide collaborative study in the Greek population. Eur J Pediatr 2024; 183:1693-1702. [PMID: 38214810 PMCID: PMC11001744 DOI: 10.1007/s00431-023-05383-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 12/05/2023] [Accepted: 12/10/2023] [Indexed: 01/13/2024]
Abstract
Multisystem inflammatory syndrome in children (MIS-C) is a rare but severe hyperinflammatory condition that may occur following SARS-CoV-2 infection. This retrospective, descriptive study of children hospitalized with multisystem inflammatory syndrome in children (MIS-C) in 12 tertiary care centers from 3/11/2020 to 12/31/2021. Demographics, clinical and laboratory characteristics, treatment and outcomes are described. Among 145 patients (95 males, median age 8.2 years) included, 123 met the WHO criteria for MIS-C, while 112 (77%) had serological evidence of SARS-CoV-2 infection. Fever was present in 99%, gastrointestinal symptoms in 77%, mucocutaneous involvement in 68% and respiratory symptoms in 28%. Fifty-five patients (38%) developed myocarditis, 29 (20%) pericarditis and 19 (13%) coronary aneurysms. Among the above cases 11/55 (20%), 1/29 (3.4%) and 5/19 (26.3%), respectively, cardiac complications had not fully resolved at discharge. Underlying comorbidities were reported in 18%. Median CRP value was 155 mg/l, ferritin 535 ng/ml, PCT 1.6 ng/ml and WBC 14.2 × 109/mm3. Most patients had elevated troponin (41.3%) and/or NT-pro-BNP (49.6%). Intravenous immunoglobulin plus corticosteroids were used in 117/145 (80.6%), monotherapy with IVIG alone in 13/145 (8.9%) and with corticosteroids alone in 2/145 (1.3%). Anti-IL1 treatment was added in 15 patients (10.3%). Thirty-three patients (23%) were admitted to the PICU, 14% developed shock and 1 required ECMO. Mortality rate was 0.68%. The incidence of MIS-C was estimated at 0.69/1000 SARS-CoV-2 infections. Patients who presented with shock had higher levels of NT-pro-BNP compared to those who did not (p < 0.001). Acute kidney injury and/or myocarditis were associated with higher risk of developing shock. CONCLUSION MIS-C is a novel, infrequent but serious disease entity. Cardiac manifestations included myocarditis and pericarditis, which resolved in most patients before discharge. Timely initiation of immunomodulatory therapy was shown to be effective. NT-pro-BNP levels may provide a better prediction and monitoring of the disease course. Further research is required to elucidate the pathogenesis, risk factors and optimal management, and long-term outcomes of this clinical entity. WHAT IS KNOWN • MIS-C is an infrequent but serious disease entity. • Patients with MIS-C present with multi-organ dysfunction, primarily involving the gastrointestinal and cardiovascular systems. WHAT IS NEW • NT-pro-BNP levels may provide a better prediction and monitoring of the disease course. • Acute kidney injury and/or myocarditis were associated with higher risk of developing shock.
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Affiliation(s)
- Stavroula Lampidi
- Second Department of Paediatrics, National and Kapodistrian University of Athens, "P. and A. Kyriakou" Children's Hospital, 11527, Athens, Greece
| | - Despoina Maritsi
- Second Department of Paediatrics, National and Kapodistrian University of Athens, "P. and A. Kyriakou" Children's Hospital, 11527, Athens, Greece
| | - Marietta Charakida
- Second Department of Paediatrics, National and Kapodistrian University of Athens, "P. and A. Kyriakou" Children's Hospital, 11527, Athens, Greece
| | - Irini Eleftheriou
- Second Department of Paediatrics, National and Kapodistrian University of Athens, "P. and A. Kyriakou" Children's Hospital, 11527, Athens, Greece
| | - Evangelia Farmaki
- First Department of Paediatrics, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642, Thessaloniki, Greece
| | - Nikos Spyridis
- Second Department of Paediatrics, National and Kapodistrian University of Athens, "P. and A. Kyriakou" Children's Hospital, 11527, Athens, Greece
| | - Konstantina Charisi
- Third Department of Paediatrics, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642, Thessaloniki, Greece
| | - Petrina Vantsi
- Third Department of Paediatrics, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642, Thessaloniki, Greece
| | - Filippos Filippatos
- First Department of Paediatrics, National and Kapodistrian University of Athens, 'Aghia Sophia' Children's Hospital, 11527, Athens, Greece
| | - Kleopatra Skourti
- First Department of Paediatrics, National and Kapodistrian University of Athens, 'Aghia Sophia' Children's Hospital, 11527, Athens, Greece
| | - Efimia Papadopoulou-Alataki
- Fourth Department of Pediatrics, Aristotle University of Thessaloniki, Papageorgiou General Hospital, 56429, Thessaloniki, Greece
| | - Kyriaki Papadopoulou-Legbelou
- Fourth Department of Pediatrics, Aristotle University of Thessaloniki, Papageorgiou General Hospital, 56429, Thessaloniki, Greece
| | | | - Ioanna N Grivea
- Department of Paediatrics, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41500, Larissa, Greece
| | - Eleni Vergadi
- Department of Paediatrics, Medical School, University of Crete, 71003, Heraklion, Greece
| | - Despoina Gkentzi
- Department of Paediatrics, University of Patras, University General Hospital of Patras, 26504, Patra, Greece
| | - Despina Dimou
- Paediatric Department, Penteli Children's Hospital, 15236, Athens, Greece
| | - Patra Koletsi
- Paediatric Department, Penteli Children's Hospital, 15236, Athens, Greece
| | - Lampros Fotis
- Third Department of Paediatrics, National and Kapodistrian University of Athens, General University Hospital "Attikon", 12462, Athens, Greece
- Department of Paediatrics, Metropolitan Hospital, 18547, Athens, Greece
- IASO Children's Hospital, 15123, Athens, Greece
| | | | | | - Katerina Kourtesi
- Third Department of Paediatrics, National and Kapodistrian University of Athens, General University Hospital "Attikon", 12462, Athens, Greece
| | - Georgios Tsolas
- Department of Paediatrics, Metropolitan Hospital, 18547, Athens, Greece
| | | | - Vassiliki Papaevangelou
- Third Department of Paediatrics, National and Kapodistrian University of Athens, General University Hospital "Attikon", 12462, Athens, Greece
| | - Gabriel Dimitriou
- Department of Paediatrics, University of Patras, University General Hospital of Patras, 26504, Patra, Greece
| | - Emmanouil Galanakis
- Department of Paediatrics, Medical School, University of Crete, 71003, Heraklion, Greece
| | - George A Syrogiannopoulos
- Department of Paediatrics, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41500, Larissa, Greece
| | - Vassiliki Spoulou
- First Department of Paediatrics, National and Kapodistrian University of Athens, 'Aghia Sophia' Children's Hospital, 11527, Athens, Greece
| | - Athanasios Michos
- First Department of Paediatrics, National and Kapodistrian University of Athens, 'Aghia Sophia' Children's Hospital, 11527, Athens, Greece
| | - Emmanuel Roilides
- Third Department of Paediatrics, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642, Thessaloniki, Greece
| | - Maria N Tsolia
- Second Department of Paediatrics, National and Kapodistrian University of Athens, "P. and A. Kyriakou" Children's Hospital, 11527, Athens, Greece.
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Soriano-Arandes A. COVID-19 clinical manifestations in children: What is the impact of the different SARS-CoV-2 variants and do we need to distinguish between different respiratory viruses? Acta Paediatr 2024; 113:640-642. [PMID: 38333991 DOI: 10.1111/apa.17149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 01/24/2024] [Accepted: 01/30/2024] [Indexed: 02/10/2024]
Affiliation(s)
- Antoni Soriano-Arandes
- Paediatric Infectious Diseases and Immunodeficiencies Unit, Children's Hospital, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Catalonia, Spain
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5
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Rizzi M, Avellis V, Messina A, Germano C, Tavella E, Dodaro V, Vitale R, Revelli A, Zola P, Picone S, Paolillo PM, Mondì V, Masturzo B, Manzoni P, Sainaghi PP. Vitamin D Supplementation in Neonatal and Infant MIS-C Following COVID-19 Infection. Int J Mol Sci 2024; 25:3712. [PMID: 38612523 PMCID: PMC11011671 DOI: 10.3390/ijms25073712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 03/20/2024] [Accepted: 03/22/2024] [Indexed: 04/14/2024] Open
Abstract
To date, the SARS-CoV-2 pandemic still represents a great clinical challenge worldwide, and effective anti-COVID-19 drugs are limited. For this reason, nutritional supplements have been investigated as adjuvant therapeutic approaches in disease management. Among such supplements, vitamin D has gained great interest, due to its immunomodulatory and anti-inflammatory actions both in adult and pediatric populations. Even if there is conflicting evidence about its prevention and/or mitigation effectiveness in SARS-CoV-2 infection, several studies demonstrated a strict correlation between hypovitaminosis D and disease severity in acute COVID-19 and MIS-C (multisystem inflammatory syndrome in children). This narrative review offers a resume of the state of the art about vitamin D's role in immunity and its clinical use in the context of the current pandemic, specially focusing on pediatric manifestations and MIS-C. It seems biologically reasonable that interventions aimed at normalizing circulating vitamin D levels could be beneficial. To help clinicians in establishing the correct prophylaxis and/or supportive therapy with vitamin D, well-designed and adequately statistically powered clinical trials involving both adult and pediatric populations are needed. Moreover, this review will also discuss the few other nutraceuticals evaluated in this context.
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Affiliation(s)
- Manuela Rizzi
- Department of Health Sciences (DiSS), Università del Piemonte Orientale (UPO), 28100 Novara, Italy
- IRCAD (Interdisciplinary Research Center of Autoimmune Diseases), Università del Piemonte Orientale (UPO), 28100 Novara, Italy
| | - Vincenzo Avellis
- School of Medicine, University of Turin, 10124 Turin, Italy
- Sant’Anna Hospital, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy (B.M.)
| | - Alessandro Messina
- School of Medicine, University of Turin, 10124 Turin, Italy
- Sant’Anna Hospital, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy (B.M.)
| | - Chiara Germano
- Sant’Anna Hospital, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy (B.M.)
- Department of Maternal, Neonatal and Infant Medicine, University Hospital “Degli Infermi”, 13875 Ponderano, Italy
| | - Elena Tavella
- School of Medicine, University of Turin, 10124 Turin, Italy
- Sant’Anna Hospital, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy (B.M.)
| | - Valentina Dodaro
- Sant’Anna Hospital, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy (B.M.)
| | - Raffaele Vitale
- School of Medicine, University of Turin, 10124 Turin, Italy
- Sant’Anna Hospital, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy (B.M.)
| | - Alberto Revelli
- School of Medicine, University of Turin, 10124 Turin, Italy
- Sant’Anna Hospital, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy (B.M.)
| | - Paolo Zola
- School of Medicine, University of Turin, 10124 Turin, Italy
- Sant’Anna Hospital, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy (B.M.)
| | - Simonetta Picone
- Neonatology and Neonatal Intensive Care Unit, Policlinico Casilino, 00169 Rome, Italy
| | - Pier Michele Paolillo
- Neonatology and Neonatal Intensive Care Unit, Policlinico Casilino, 00169 Rome, Italy
| | - Vito Mondì
- Neonatology and Neonatal Intensive Care Unit, Policlinico Casilino, 00169 Rome, Italy
| | - Bianca Masturzo
- Sant’Anna Hospital, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy (B.M.)
- Department of Maternal, Neonatal and Infant Medicine, University Hospital “Degli Infermi”, 13875 Ponderano, Italy
| | - Paolo Manzoni
- Sant’Anna Hospital, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy (B.M.)
- Department of Maternal, Neonatal and Infant Medicine, University Hospital “Degli Infermi”, 13875 Ponderano, Italy
| | - Pier Paolo Sainaghi
- IRCAD (Interdisciplinary Research Center of Autoimmune Diseases), Università del Piemonte Orientale (UPO), 28100 Novara, Italy
- Department of Translational Medicine (DiMeT), Università del Piemonte Orientale (UPO), 28100 Novara, Italy
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Bellini T, Brisca G, Mariani M, Caorsi R, Bustaffa M, Drago E, Strati MF, Piccotti E, Moscatelli A, Gattorno M, Castagnola E. Epidemiological and clinical evolution of multisystem inflammatory syndrome in children throughout the SARS-CoV-2 pandemic in a tertiary Italian children's hospital. Acta Paediatr 2024; 113:523-530. [PMID: 38066729 DOI: 10.1111/apa.17054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 10/19/2023] [Accepted: 11/28/2023] [Indexed: 02/13/2024]
Abstract
Multisystem inflammatory syndrome in children (MIS-C) is a potentially life-threatening disease temporally linked to SARS-CoV-2 whose incidence and clinical presentation may have been altered by the different SARS-CoV-2 variants and by vaccination. METHODS We retrospectively collected the data of all MIS-C cases admitted to the Gaslini Children's Hospital, the hub for SARS-CoV-2 related diseases in Liguria region, Italy, from 01 October 2020, to 30 November 2022, evaluating the ratio between MIS-C cases and (1) COVID-19 paediatric cases in our region, (2) emergency department admissions and (3) emergency department febrile patients. We also compared MIS-C incidence in pre- post-vaccination periods. RESULTS We observed a significant global decline in the incidence of MIS-Cover the four variant periods and after the starting of vaccination whereas clinical features, therapeutic management and severity did not significantly vary. CONCLUSIONS In our setting, we demonstrated a significant decrease of MIS-C incidence according to the predominant variant and including not vaccinated children. Regardless of variant type, the patients showed similar phenotypes and severity throughout the pandemic. SARS-CoV-2 variants as well as immune protection after previous infections and/or vaccination may have interacted by playing different roles and reducing the incidence of MIS-C.
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Affiliation(s)
- Tommaso Bellini
- Pronto Soccorso e Medicina d'Urgenza, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Giacomo Brisca
- Terapia Semintensiva, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Marcello Mariani
- Pediatria e Malattie Infettive, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Roberta Caorsi
- Centro Malattie Autoinfiammatorie e Immunodeficienze, Istituto Giannina Gaslini, IRCCS, Genoa, Italy
| | - Marta Bustaffa
- Pronto Soccorso e Medicina d'Urgenza, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Enrico Drago
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantile (DINOGMI), University of genoa, Genoa, Italy
| | - Marina Francesca Strati
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantile (DINOGMI), University of genoa, Genoa, Italy
| | - Emanuela Piccotti
- Pronto Soccorso e Medicina d'Urgenza, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | | | - Marco Gattorno
- Centro Malattie Autoinfiammatorie e Immunodeficienze, Istituto Giannina Gaslini, IRCCS, Genoa, Italy
| | - Elio Castagnola
- Pediatria e Malattie Infettive, IRCCS Istituto Giannina Gaslini, Genoa, Italy
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7
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Moreno Rojas AF, Bainto E, Harvey H, Tremoulet AH, Burns JC, Dummer KB. SARS-CoV-2 variants are associated with different clinical courses in children with MIS-C. World J Pediatr 2024; 20:143-152. [PMID: 38133726 PMCID: PMC10884140 DOI: 10.1007/s12519-023-00778-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 11/05/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Recent infection with SARS‑CoV‑2 in children has been associated with multisystem inflammatory syndrome in children (MIS-C). SARS‑CoV‑2 has undergone different mutations. Few publications exist about specific variants and their correlation with the severity of MIS-C. METHODS This was a single-center, retrospective study including all patients admitted with MIS-C at Rady Children's Hospital-San Diego between May 2020 and March 2022. Local epidemiologic data, including viral genomic information, were obtained from public records. Demographics, clinical presentation, laboratory values, and outcomes were obtained from electronic medical records. RESULTS The analysis included 104 pediatric patients. Four MIS-C waves were identified. Circulating variants in San Diego during the first wave included clades 20A to C. During the second wave, there were variants from clades 20A to C, 20G, 21C (Epsilon), 20I (Alpha), and 20J (Gamma). The third wave had Delta strains (clades 21A, 21I, and 21J), and the fourth had Omicron variants (clades 21K, 21L, and 22C). MIS-C presented with similar symptoms and laboratory findings across all waves. More patients were admitted to the pediatric intensive care unit (PICU) (74%) and required inotropic support (63%) during the second wave. None of the patients required mechanical circulatory support, and only two required invasive ventilatory support. There was no mortality. CONCLUSIONS The various strains of SARS-CoV-2 triggered MIS-C with differing severities, with the second wave having a more severe clinical course. Whether the differences in disease severity across variants were due to changes in the virus or other factors remains unknown.
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Affiliation(s)
- Andres F Moreno Rojas
- Department of Pediatrics, Division of Pediatric Cardiology, University of California San Diego, and Rady Children's Hospital, 3020 Children's Way MC 5004, San Diego, CA, 92123, USA
| | | | - Helen Harvey
- Department of Pediatrics, Division of Pediatric Critical Care, University of California San Diego, and Rady Children's Hospital, San Diego, CA, USA
| | - Adriana H Tremoulet
- Kawasaki Disease Research Center, La Jolla, CA, USA
- Department of Pediatrics, University of California San Diego, and Rady Children's Hospital, San Diego, CA, USA
| | - Jane C Burns
- Kawasaki Disease Research Center, La Jolla, CA, USA
- Department of Pediatrics, University of California San Diego, and Rady Children's Hospital, San Diego, CA, USA
| | - Kirsten B Dummer
- Department of Pediatrics, Division of Pediatric Cardiology, University of California San Diego, and Rady Children's Hospital, 3020 Children's Way MC 5004, San Diego, CA, 92123, USA.
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8
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Zhang YF, Xia CY, Yang Q, Cai Y, Li DT, Jiang Q, Hu P. The protective effects of pediatric vaccination on multisystem inflammatory syndrome in children stratified by vaccine status, types and virus variants. Int Immunopharmacol 2023; 125:111105. [PMID: 38149578 DOI: 10.1016/j.intimp.2023.111105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 10/19/2023] [Accepted: 10/19/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND Few studies highlight the stratification of COVID-19 vaccine effectiveness on MIS-C according to vaccine status, types and SARS-COV-2 variants. METHODS A web-based analysis was conducted through searches of PubMed, Web of Science and Medline databases from January 1, 2020, to May 16, 2023. The search terms used were (multisystem inflammatory syndrome in children OR MIS-C OR PIMS OR PIMS-TS) AND (COVID-19 OR SARS-CoV-2) AND (vaccine OR vaccination) AND (children OR adolescents OR pediatric). RESULTS 6701 children from 13 studies met the MIS-C definition. 92.1 % (1332/1446) of MIS-C cases were unvaccinated, whereas partial vaccination and full vaccination were 3.7 % (54/1446) and 4.2 % (60/1446)respectively. In the two studies encompassing 41 vaccinated MIS-C cases, 34 (82.9 %) received BNT162b2, 2 (4.9 %) received mRNA-1273, 4 (9.8 %) received Sinovac vaccine, and only one received a heterologous primary-boost regimen. Among 838 vaccinated MIS-C cases with different SARS-COV-2 variants, 23(2.8 %) were infected by the Wild-type, 80(9.5 %) by the Alpha variant, 521(62.2 %) by the Delta variant, and 214(25.5 %) by the Omicron variant. A significant difference was observed in vaccination rates among MIS-C cases across different variant pandemics (χ2 = 37.79, P < 0.001). The highest vaccination rate (26.3 %) occurred in the Alpha predominant period, thereafter dropped to 5.0 % in the Delta predominant period, and then increased to 12.6 % in the Omicron predominant period. CONCLUSIONS Heterologous vaccination might provide a slightly more protective effect than homologous manner for MIS-C. As the virus mutates over time, its pathogenicity to MIS-C degrades among vaccinated individuals.
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Affiliation(s)
- Yan Fang Zhang
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Cai Yun Xia
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Qian Yang
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Ying Cai
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Dao Ting Li
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Qi Jiang
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Peng Hu
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
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9
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Sperotto F, Gutiérrez-Sacristán A, Makwana S, Li X, Rofeberg VN, Cai T, Bourgeois FT, Omenn GS, Hanauer DA, Sáez C, Bonzel CL, Bucholz E, Dionne A, Elias MD, García-Barrio N, González TG, Issitt RW, Kernan KF, Laird-Gion J, Maidlow SE, Mandl KD, Ahooyi TM, Moraleda C, Morris M, Moshal KL, Pedrera-Jiménez M, Shah MA, South AM, Spiridou A, Taylor DM, Verdy G, Visweswaran S, Wang X, Xia Z, Zachariasse JM, Newburger JW, Avillach P. Clinical phenotypes and outcomes in children with multisystem inflammatory syndrome across SARS-CoV-2 variant eras: a multinational study from the 4CE consortium. EClinicalMedicine 2023; 64:102212. [PMID: 37745025 PMCID: PMC10511777 DOI: 10.1016/j.eclinm.2023.102212] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/22/2023] [Accepted: 08/29/2023] [Indexed: 09/26/2023] Open
Abstract
Background Multisystem inflammatory syndrome in children (MIS-C) is a severe complication of SARS-CoV-2 infection. It remains unclear how MIS-C phenotypes vary across SARS-CoV-2 variants. We aimed to investigate clinical characteristics and outcomes of MIS-C across SARS-CoV-2 eras. Methods We performed a multicentre observational retrospective study including seven paediatric hospitals in four countries (France, Spain, U.K., and U.S.). All consecutive confirmed patients with MIS-C hospitalised between February 1st, 2020, and May 31st, 2022, were included. Electronic Health Records (EHR) data were used to calculate pooled risk differences (RD) and effect sizes (ES) at site level, using Alpha as reference. Meta-analysis was used to pool data across sites. Findings Of 598 patients with MIS-C (61% male, 39% female; mean age 9.7 years [SD 4.5]), 383 (64%) were admitted in the Alpha era, 111 (19%) in the Delta era, and 104 (17%) in the Omicron era. Compared with patients admitted in the Alpha era, those admitted in the Delta era were younger (ES -1.18 years [95% CI -2.05, -0.32]), had fewer respiratory symptoms (RD -0.15 [95% CI -0.33, -0.04]), less frequent non-cardiogenic shock or systemic inflammatory response syndrome (SIRS) (RD -0.35 [95% CI -0.64, -0.07]), lower lymphocyte count (ES -0.16 × 109/uL [95% CI -0.30, -0.01]), lower C-reactive protein (ES -28.5 mg/L [95% CI -46.3, -10.7]), and lower troponin (ES -0.14 ng/mL [95% CI -0.26, -0.03]). Patients admitted in the Omicron versus Alpha eras were younger (ES -1.6 years [95% CI -2.5, -0.8]), had less frequent SIRS (RD -0.18 [95% CI -0.30, -0.05]), lower lymphocyte count (ES -0.39 × 109/uL [95% CI -0.52, -0.25]), lower troponin (ES -0.16 ng/mL [95% CI -0.30, -0.01]) and less frequently received anticoagulation therapy (RD -0.19 [95% CI -0.37, -0.04]). Length of hospitalization was shorter in the Delta versus Alpha eras (-1.3 days [95% CI -2.3, -0.4]). Interpretation Our study suggested that MIS-C clinical phenotypes varied across SARS-CoV-2 eras, with patients in Delta and Omicron eras being younger and less sick. EHR data can be effectively leveraged to identify rare complications of pandemic diseases and their variation over time. Funding None.
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Affiliation(s)
- Francesca Sperotto
- Department of Cardiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, United States
| | - Alba Gutiérrez-Sacristán
- Department of Biomedical Informatics, Harvard Medical School, 10 Shattuck Street, Boston, MA 02115, United States
| | - Simran Makwana
- Department of Biomedical Informatics, Harvard Medical School, 10 Shattuck Street, Boston, MA 02115, United States
| | - Xiudi Li
- Department of Biostatistics, Harvard School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States
| | - Valerie N. Rofeberg
- Department of Cardiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, United States
| | - Tianxi Cai
- Department of Biomedical Informatics, Harvard Medical School, 10 Shattuck Street, Boston, MA 02115, United States
| | - Florence T. Bourgeois
- Department of Pediatrics, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, United States
| | - Gilbert S. Omenn
- Dept of Computational Medicine & Bioinformatics, Internal Medicine, Human Genetics, & Public Health, University of Michigan, 2017 Palmer Commons, Ann Arbor, MI 48109-2218, United States
| | - David A. Hanauer
- Department of Learning Health Sciences, University of Michigan Medical School, 100-107 NCRC, 2800 Plymouth Road, Ann Arbor, MI 48109, United States
| | - Carlos Sáez
- Biomedical Data Science Lab, Instituto Universitario de Tecnologías de la Información y Comunicaciones, Universitat Politécnica de Valéncia, Camino de Vera S/N, Valencia 46022, Spain
| | - Clara-Lea Bonzel
- Department of Biomedical Informatics, Harvard Medical School, 10 Shattuck Street, Boston, MA 02115, United States
| | - Emily Bucholz
- Department of Cardiology, Children's Hospital Colorado, University of Colorado Anschutz, 13123 E. 16th Ave, Aurora, CO 80045, United States
| | - Audrey Dionne
- Department of Cardiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, United States
| | - Matthew D. Elias
- Division of Cardiology, The Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, United States
| | - Noelia García-Barrio
- Health Informatics, Hospital Universitario 12 de Octubre, Av. de Córdoba, s/n, Madrid 28041, Spain
| | - Tomás González González
- Health Informatics, Hospital Universitario 12 de Octubre, Av. de Córdoba, s/n, Madrid 28041, Spain
| | - Richard W. Issitt
- Digital Research, Informatics and Virtual Environments (DRIVE), Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, United Kingdom
| | - Kate F. Kernan
- Department of Critical Care Medicine, University of Pittsburgh, 3550 Terrace Street, Pittsburgh, PA 15213, United States
| | - Jessica Laird-Gion
- Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, United States
| | - Sarah E. Maidlow
- Michigan Institute for Clinical and Health Research (MICHR) Informatics, University of Michigan, NCRC Bldg 400, 2800 Plymouth Road, Ann Arbor, MI 48109, United States
| | - Kenneth D. Mandl
- Computational Health Informatics Program, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, United States
| | - Taha Mohseni Ahooyi
- Department of Biomedical Health Informatics, The Children's Hospital of Philadelphia, Roberts Building, 734 Schuylkill Ave, Philadelphia, PA 19146, United States
| | - Cinta Moraleda
- Pediatric Infectious Disease Department, Hospital Universitario 12 de Octubre, Av. de Córdoba, s/n, Madrid 28041, Spain
| | - Michele Morris
- Department of Biomedical Informatics, University of Pittsburgh, 5607 Baum Blvd, Pittsburgh, PA 15206, United States
| | - Karyn L. Moshal
- Department of Infectious Diseases, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, United Kingdom
| | - Miguel Pedrera-Jiménez
- Health Informatics, Hospital Universitario 12 de Octubre, Av. de Córdoba, s/n, Madrid 28041, Spain
| | - Mohsin A. Shah
- Digital Research, Informatics and Virtual Environments (DRIVE), Great Ormond Street Hospital for Children, DRIVE, 40 Bernard St, London WC1N 1LE, United Kingdom
| | - Andrew M. South
- Department of Pediatrics-Section of Nephrology, Brenner Children’s, Wake Forest University School of Medicine, Medical Center Boulevard, Winston Salem, NC 27157, United States
| | - Anastasia Spiridou
- Data Research, Innovation and Virtual Environments, Great Ormond Street Hospital for Children, DRIVE, 40 Bernard St, London WC1N 1LE, United Kingdom
| | - Deanne M. Taylor
- Department of Biomedical Health Informatics, The Children's Hospital of Philadelphia, United States
- The Department of Pediatrics, University of Pennsylvania Perelman Medical School, 3601 Civic Center Blvd, 6032 Colket, Philadelphia, PA 19104, United States
| | - Guillaume Verdy
- IAM Unit, Bordeaux University Hospital, Place amélie rabat Léon, Bordeaux 33076, France
| | - Shyam Visweswaran
- Department of Biomedical Informatics, University of Pittsburgh, 5607 Baum Blvd, Pittsburgh, PA 15206, United States
| | - Xuan Wang
- Department of Biomedical Informatics, Harvard Medical School, 10 Shattuck Street, Boston, MA 02115, United States
| | - Zongqi Xia
- Department of Neurology, University of Pittsburgh, 3501 5th Avenue, BST-3 Suite 7014, Pittsburgh, PA 15260, United States
| | - Joany M. Zachariasse
- Department of Biomedical Informatics, Harvard Medical School, 10 Shattuck Street, Boston, MA 02115, United States
| | - Jane W. Newburger
- Department of Cardiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, United States
| | - Paul Avillach
- Department of Biomedical Informatics, Harvard Medical School, 10 Shattuck Street, Boston, MA 02115, United States
- Computational Health Informatics Program, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, United States
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10
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Soriano-Arandes A, Brett A, Buonsenso D, Emilsson L, de la Fuente Garcia I, Gkentzi D, Helve O, Kepp KP, Mossberg M, Muka T, Munro A, Papan C, Perramon-Malavez A, Schaltz-Buchholzer F, Smeesters PR, Zimmermann P. Policies on children and schools during the SARS-CoV-2 pandemic in Western Europe. Front Public Health 2023; 11:1175444. [PMID: 37564427 PMCID: PMC10411527 DOI: 10.3389/fpubh.2023.1175444] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 06/26/2023] [Indexed: 08/12/2023] Open
Abstract
During the pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), mitigation policies for children have been a topic of considerable uncertainty and debate. Although some children have co-morbidities which increase their risk for severe coronavirus disease (COVID-19), and complications such as multisystem inflammatory syndrome and long COVID, most children only get mild COVID-19. On the other hand, consistent evidence shows that mass mitigation measures had enormous adverse impacts on children. A central question can thus be posed: What amount of mitigation should children bear, in response to a disease that is disproportionally affecting older people? In this review, we analyze the distinct child versus adult epidemiology, policies, mitigation trade-offs and outcomes in children in Western Europe. The highly heterogenous European policies applied to children compared to adults did not lead to significant measurable differences in outcomes. Remarkably, the relative epidemiological importance of transmission from school-age children to other age groups remains uncertain, with current evidence suggesting that schools often follow, rather than lead, community transmission. Important learning points for future pandemics are summarized.
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Affiliation(s)
- Antoni Soriano-Arandes
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Ana Brett
- Infectious Diseases Unit and Emergency Service, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Milan, Italy
| | - Louise Emilsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Solna, Sweden
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Isabel de la Fuente Garcia
- Pediatric Infectious Diseases, National Pediatric Center, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - Despoina Gkentzi
- Department of Paediatrics, Patras Medical School, Patras, Greece
| | - Otto Helve
- Department of Health Security, Institute for Health and Welfare, Helsinki, Finland
- Pediatric Research Center, Children's Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Kasper P. Kepp
- Section of Biophysical and Biomedicinal Chemistry, DTU Chemistry, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Maria Mossberg
- Department of Pediatrics, Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Taulant Muka
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Epistudia, Bern, Switzerland
| | - Alasdair Munro
- NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
- Faculty of Medicine, Institute of Life Sciences, University of Southampton, Southampton, United Kingdom
| | - Cihan Papan
- Institute for Hygiene and Public Health, University Hospital Bonn, Bonn, Germany
| | - Aida Perramon-Malavez
- Computational Biology and Complex Systems (BIOCOM-SC) Group, Department of Physics, Universitat Politècnica de Catalunya (UPC·BarcelonaTech), Barcelona, Spain
| | | | - Pierre R. Smeesters
- Department of Pediatrics, University Hospital Brussels, Academic Children’s Hospital Queen Fabiola, Université Libre de Bruxelles, Brussels, Belgium
- Molecular Bacteriology Laboratory, Université Libre de Bruxelles, Brussels, Belgium
| | - Petra Zimmermann
- Department of Community Health, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
- Department of Paediatrics, Fribourg Hospital, Fribourg, Switzerland
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11
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Laird-Gion J, Dionne A, Gauvreau K, Baker A, Day-Lewis M, de Ferranti S, Friedman K, Khan N, Mahanta S, Son MB, Sperotto F, Newburger JW. MIS-C across three SARS-CoV-2 variants: Changes in COVID-19 testing and clinical characteristics in a cohort of U.S. children. Eur J Pediatr 2023; 182:2865-2872. [PMID: 37055630 PMCID: PMC10101535 DOI: 10.1007/s00431-023-04968-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/21/2023] [Accepted: 03/31/2023] [Indexed: 04/15/2023]
Abstract
As new variants of SARS-Co-V 2 have emerged over time and Omicron sub-variants have become dominant, the severity of illness from COVID-19 has declined despite greater transmissibility. There are fewer data on how the history, diagnosis, and clinical characteristics of multisystem inflammatory syndrome in children (MIS-C) have changed with evolution in SARS-CoV-2 variants. We conducted a retrospective cohort study of patients hospitalized with MIS-C between April 2020 and July 2022 in a tertiary referral center. Patients were sorted into Alpha, Delta, and Omicron variant cohorts by date of admission and using national and regional data on variant prevalence. Among 108 patients with MIS-C, significantly more patients had a documented history of COVID-19 in the two months before MIS-C during Omicron (74%) than during Alpha (42%) (p = 0.03). Platelet count and absolute lymphocyte count were lowest during Omicron, without significant differences in other laboratory tests. However, markers of clinical severity, including percentage with ICU admission, length of ICU stay, use of inotropes, or left ventricular dysfunction, did not differ across variants. This study is limited by its small, single-center case series design and by classification of patients into era of variant by admission date rather than genomic testing of SARS- CoV-2 samples. Conclusion: Antecedent COVID-19 was more often documented in the Omicron than Alpha or Delta eras, but clinical severity of MIS-C was similar across variant eras. What is Known: • There has been a decrease in incidence of MIS-C in children despite widespread infection with new variants of COVID-19. • Data has varied on if the severity of MIS-C has changed over time across different variant infections. What is New: • MIS-C patients were significantly more likely to report a known prior infection with SARS-CoV-2 during Omicron than during Alpha. • There was no difference in severity of MIS-C between the Alpha, Delta, and Omicron cohorts in our patient population.
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Affiliation(s)
- Jessica Laird-Gion
- Division of Cardiology, Boston Children's Hospital, Boston, MA, USA.
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
| | - Audrey Dionne
- Division of Cardiology, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Kimberlee Gauvreau
- Division of Cardiology, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Annette Baker
- Division of Cardiology, Boston Children's Hospital, Boston, MA, USA
| | - Megan Day-Lewis
- Division of Immunology, Boston Children's Hospital, Boston, MA, USA
| | - Sarah de Ferranti
- Division of Cardiology, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Kevin Friedman
- Division of Cardiology, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Numaira Khan
- Division of Cardiology, Boston Children's Hospital, Boston, MA, USA
| | - Simran Mahanta
- Division of Cardiology, Boston Children's Hospital, Boston, MA, USA
| | - Mary Beth Son
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- Division of Immunology, Boston Children's Hospital, Boston, MA, USA
| | - Francesca Sperotto
- Division of Cardiology, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Jane W Newburger
- Division of Cardiology, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
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