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Liguori V, Zinzi A, Gaio M, Riccardi C, Di Costanzo L, Gargano F, Carpentieri C, D’Elia M, Bernardi FF, Trama U, Capuano A, Rafaniello C. Multisystem Inflammatory Syndrome in Children Following COVID-19 Vaccination: A Sex-Stratified Analysis of the VAERS Database Using Brighton Collaboration Criteria. Pharmaceuticals (Basel) 2023; 16:1231. [PMID: 37765039 PMCID: PMC10535674 DOI: 10.3390/ph16091231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/04/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023] Open
Abstract
Multisystem inflammatory syndrome in children (MIS-c) is an uncommon, but serious, inflammatory response that occurs after SARS-CoV-2 infection. As time went by, MIS-c was also reported as a potential adverse event following COVID-19 vaccination. A descriptive analysis was performed of Individual Case Safety Reports (ICSRs) associated with anti COVID-19 vaccines and related to the pediatric population from 2020 to 2022. The present pharmacovigilance study aimed to describe cases of MIS-c following COVID-19 vaccination, stratified by sex, reported in the Vaccine Adverse Events Reporting System (VAERS) and meeting the Brighton Collaboration criteria for case definition. We assessed all suspected cases through the case definition and classification of the Brighton Collaboration Group, and only definitive, probable, and possible cases were included in the analysis. The Reporting Odds Ratio (ROR) with 95% Confidence Interval (CI) was computed to assess if males have a lower/higher probability of reporting ICSRs with MIS-c compared with females. Overall, we found 79 cases of potentially reported MIS-c following vaccination. This study demonstrated that MIS-c following vaccination was more commonly reported for male subjects with a median age of 10 years (IQR 10.0-11.4), especially after the first dose of anti COVID-19 vaccines with a median time to onset of 27 days. Even so, the rate of occurrence of MIS-c following anti COVID-19 vaccines is lower (0.12/100,000 vaccinated subjects; 95% CI, 0.12-0.13). Overall, all ICSRs were serious and caused or prolonged hospitalization. Finally, disproportionality analysis showed that males had a higher reporting probability of MIS-c compared with females following immunization with mRNA COVID-19 vaccines. Since only a few years of marketing are available, further data from real-life contexts are needed.
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Affiliation(s)
- Valerio Liguori
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, 80138 Naples, Italy; (V.L.); (M.G.); (C.R.); (A.C.); (C.R.)
- Section of Pharmacology “L. Donatelli”, Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Alessia Zinzi
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, 80138 Naples, Italy; (V.L.); (M.G.); (C.R.); (A.C.); (C.R.)
- Section of Pharmacology “L. Donatelli”, Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Mario Gaio
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, 80138 Naples, Italy; (V.L.); (M.G.); (C.R.); (A.C.); (C.R.)
- Section of Pharmacology “L. Donatelli”, Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Consiglia Riccardi
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, 80138 Naples, Italy; (V.L.); (M.G.); (C.R.); (A.C.); (C.R.)
- Section of Pharmacology “L. Donatelli”, Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Luigi Di Costanzo
- Section of Pharmacology “L. Donatelli”, Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Francesca Gargano
- Regional Direction for Health Management, Pharmaceutical Unit, 80131 Naples, Italy; (F.G.); (C.C.); (M.D.); (F.F.B.); (U.T.)
| | - Claudia Carpentieri
- Regional Direction for Health Management, Pharmaceutical Unit, 80131 Naples, Italy; (F.G.); (C.C.); (M.D.); (F.F.B.); (U.T.)
| | - Maria D’Elia
- Regional Direction for Health Management, Pharmaceutical Unit, 80131 Naples, Italy; (F.G.); (C.C.); (M.D.); (F.F.B.); (U.T.)
| | - Francesca Futura Bernardi
- Regional Direction for Health Management, Pharmaceutical Unit, 80131 Naples, Italy; (F.G.); (C.C.); (M.D.); (F.F.B.); (U.T.)
| | - Ugo Trama
- Regional Direction for Health Management, Pharmaceutical Unit, 80131 Naples, Italy; (F.G.); (C.C.); (M.D.); (F.F.B.); (U.T.)
| | - Annalisa Capuano
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, 80138 Naples, Italy; (V.L.); (M.G.); (C.R.); (A.C.); (C.R.)
- Section of Pharmacology “L. Donatelli”, Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Concetta Rafaniello
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, 80138 Naples, Italy; (V.L.); (M.G.); (C.R.); (A.C.); (C.R.)
- Section of Pharmacology “L. Donatelli”, Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
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Pabst LM, Zyck SA, Youssef P. Successful thrombectomy in a pediatric patient with large vessel occlusion and COVID-19 related multisystem inflammatory syndrome. Interv Neuroradiol 2022; 29:214-216. [PMID: 35167391 PMCID: PMC8851050 DOI: 10.1177/15910199221080873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This is a case report of a child with multisystem inflammatory syndrome in children (MIS-C) complicated by an acute ischemic stroke with right M1 occlusion and large penumbra who underwent thrombectomy with TICI 3 recanalization. There were no complications and the patient had improvement in the pediatric NIHSS from 16 to 3 in the subsequent days. This is the first known report of successful mechanical thrombectomy performed in a pediatric patient with MIS-C associated with COVID-19.
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Affiliation(s)
- Lisa M Pabst
- Department of Pediatrics, Division of Neurology, 2650Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA
| | - Stephanie A Zyck
- Department of Neurosurgery, 12306The Ohio State University Wexner Medical Center, 370W 9th Ave, Columbus, OH, 43210, USA
| | - Patrick Youssef
- Department of Neurosurgery, 12306The Ohio State University Wexner Medical Center, 370W 9th Ave, Columbus, OH, 43210, USA
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Jenkins E, Sherry W, Smith AGC, Rostad BS, Rostad CA, Jones K, Jaggi P. Retropharyngeal Edema and Neck Pain in Multisystem Inflammatory Syndrome in Children ( MIS-c). J Pediatric Infect Dis Soc 2021; 10:922-925. [PMID: 34173667 PMCID: PMC8557366 DOI: 10.1093/jpids/piab050] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/03/2021] [Indexed: 12/31/2022]
Abstract
We defined the prevalence of neck pain, trismus, or dysphagia (28.4%) and retropharyngeal edema (2.9%) among 137 patients with multisystem inflammatory syndrome in children (MIS-c). Retropharyngeal edema or phlegmon has been documented radiologically in at least 9 children. Symptoms of neck inflammation are common in MIS-c.
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Affiliation(s)
- Elan Jenkins
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA,Emory + Children’s Pediatric Institute, Atlanta, Georgia, USA,Corresponding Author: Elan Jenkins, MD, Department of Pediatrics, Hospitalist Group, Children’s Healthcare of Atlanta, 1405 Clifton Rd NE, Atlanta, GA, 30322.
| | - Whitney Sherry
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA,Emory + Children’s Pediatric Institute, Atlanta, Georgia, USA
| | | | - Bradley S Rostad
- Department of Radiology and Imaging Sciences, Children’s Healthcare of Atlanta and Emory University School of Medicine, Atlanta, Georgia, USA
| | - Christina A Rostad
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA,Center for Childhood Infections and Vaccinations, Children’s Healthcare of Atlanta and Emory University School of Medicine, Atlanta, Georgia, USA
| | - Kaitlin Jones
- Children’s Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Preeti Jaggi
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA,Center for Childhood Infections and Vaccinations, Children’s Healthcare of Atlanta and Emory University School of Medicine, Atlanta, Georgia, USA
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Shahin W, Rabie W, Alyossof O, Alasiri M, Alfaki M, Mahmoud E, Hijazi M, Faraidi HE, Alahmari H. COVID-19 in children ranging from asymptomatic to a multi-system inflammatory disease: A single-center study. Saudi Med J 2021; 42:299-305. [PMID: 33632909 PMCID: PMC7989263 DOI: 10.15537/smj.2021.42.3.20200625] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 01/20/2021] [Indexed: 12/24/2022] Open
Abstract
Objectives: To identify clinical and laboratory characteristics of the Saudi children with confirmed COVID-19. Methods: Eighty-eight children (0-14 years) with COVID-19 who were admitted to Prince Sultan Military Medical City (PSMMC), Riyadh, Saudi Arabia from April to June 2020 were recruited. Results: Mean age was 5.74 ± 4.7 years with 41 (49.4%) males and 42 (50.6%) females. The length of hospital stay (LOS) ranged from 1 to 17 days. The main source of infection was infected family members. Mean values of C-reactive protein (CRP), serum ferritin, and lactate dehydrogenase (LDH) were noticeably above normal. Degree of severity and length of stay was significantly correlated with lymphopenia (r= -0.36; p=0.001), whereas it was positively correlated with absolute neutrophil count and with high inflammatory markers, such as CRP, LDH, and others. Conclusions: Identifying the clinical and laboratory characteristics of the Saudi children with confirmed COVID-19 will improve understanding of this disease’s presentation and will help put rapid and proper management strategies into place to face this pandemic. A high index of suspicion is needed for cases presenting with multi-system inflammatory disease, which represented 5.7% of the included study population.
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Affiliation(s)
- Walaa Shahin
- From the Department of Pediatrics (Shahin), Faculty of Medicine, from the Department of Clinical and Chemical Pathology (Rabie), Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt; and from the Department of Pediatrics (Shahin, Alyossof, Alasiri, Alfaki, Mahmoud, Hijazi, El Faraidi, Alahmari), Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia.
- Address correspondence and reprint request to: Dr. Walaa Shahin, Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia. E-mail: ORCID ID: http://orcid.org/0000-0003-1040-3666
| | - Walaa Rabie
- From the Department of Pediatrics (Shahin), Faculty of Medicine, from the Department of Clinical and Chemical Pathology (Rabie), Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt; and from the Department of Pediatrics (Shahin, Alyossof, Alasiri, Alfaki, Mahmoud, Hijazi, El Faraidi, Alahmari), Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Osama Alyossof
- From the Department of Pediatrics (Shahin), Faculty of Medicine, from the Department of Clinical and Chemical Pathology (Rabie), Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt; and from the Department of Pediatrics (Shahin, Alyossof, Alasiri, Alfaki, Mahmoud, Hijazi, El Faraidi, Alahmari), Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Mohammed Alasiri
- From the Department of Pediatrics (Shahin), Faculty of Medicine, from the Department of Clinical and Chemical Pathology (Rabie), Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt; and from the Department of Pediatrics (Shahin, Alyossof, Alasiri, Alfaki, Mahmoud, Hijazi, El Faraidi, Alahmari), Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Mohamed Alfaki
- From the Department of Pediatrics (Shahin), Faculty of Medicine, from the Department of Clinical and Chemical Pathology (Rabie), Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt; and from the Department of Pediatrics (Shahin, Alyossof, Alasiri, Alfaki, Mahmoud, Hijazi, El Faraidi, Alahmari), Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Elamin Mahmoud
- From the Department of Pediatrics (Shahin), Faculty of Medicine, from the Department of Clinical and Chemical Pathology (Rabie), Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt; and from the Department of Pediatrics (Shahin, Alyossof, Alasiri, Alfaki, Mahmoud, Hijazi, El Faraidi, Alahmari), Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Muwaffak Hijazi
- From the Department of Pediatrics (Shahin), Faculty of Medicine, from the Department of Clinical and Chemical Pathology (Rabie), Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt; and from the Department of Pediatrics (Shahin, Alyossof, Alasiri, Alfaki, Mahmoud, Hijazi, El Faraidi, Alahmari), Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Huda El Faraidi
- From the Department of Pediatrics (Shahin), Faculty of Medicine, from the Department of Clinical and Chemical Pathology (Rabie), Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt; and from the Department of Pediatrics (Shahin, Alyossof, Alasiri, Alfaki, Mahmoud, Hijazi, El Faraidi, Alahmari), Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Hassan Alahmari
- From the Department of Pediatrics (Shahin), Faculty of Medicine, from the Department of Clinical and Chemical Pathology (Rabie), Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt; and from the Department of Pediatrics (Shahin, Alyossof, Alasiri, Alfaki, Mahmoud, Hijazi, El Faraidi, Alahmari), Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia.
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