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Shingleton J, Burton L, Williams HE, Finnie TJR, Bennett E, Birrell P, Kenny S, Watson-Koszel T, Viner R, Arditi M, DeAngelis D, Gent N, Ladhani SN. Risk of paediatric multisystem inflammatory syndrome (PIMS-TS) during the SARS-CoV-2 alpha and delta variant waves: National observational and modelling study, 2020-21, England. Front Pediatr 2022; 10:1034280. [PMID: 36545670 PMCID: PMC9762156 DOI: 10.3389/fped.2022.1034280] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022] Open
Abstract
Objectives Paediatric Multisystem Inflammatory Syndrome (PIMS-TS) is a rare life-threatening complication that typically occurs several weeks after SARS-CoV-2 infection in children and young people (CYP). We used national and regional-level data from the COVID-19 pandemic waves in England to develop a model to predict PIMS-TS cases. Methods SARS-CoV-2 infections in CYP aged 0-15 years in England were estimated using the PHE-Cambridge real-time model. PIMS-TS cases were identified through the British Paediatric Surveillance Unit during (March-June 2020) and through Secondary Uses Services (SUS) from November 2020. A predictive model was developed to estimate PIMS-TS risk and lag times after SARS-CoV-2 infections. Results During the Alpha wave, the model accurately predicted PIMS-TS cases (506 vs. 502 observed cases), with a median estimated risk of 0.038% (IQR, 0.037-0.041%) of paediatric SARS-CoV-2 infections. For the Delta wave, the median risk of PIMS-TS was significantly lower at 0.026% (IQR, 0.025-0.029%), with 212 observed PIMS-TS cases compared to 450 predicted by the model. Conclusions The model accurately predicted national and regional PIMS-TS cases in CYP during the Alpha wave. PIMS-TS cases were 53% lower than predicted during the Delta wave. Further studies are needed to understand the mechanisms of the observed lower risk with the Delta variant.
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Affiliation(s)
- Joseph Shingleton
- Emergency Preparedness Response and Resilience Directorate, UK Health Security Agency, Porton Down, London, United Kingdom
- Joint Modelling Team, UK Health Security Agency, London, United Kingdom
| | - Lucy Burton
- Emergency Preparedness Response and Resilience Directorate, UK Health Security Agency, Porton Down, London, United Kingdom
- Joint Modelling Team, UK Health Security Agency, London, United Kingdom
| | - Hannah E. Williams
- Emergency Preparedness Response and Resilience Directorate, UK Health Security Agency, Porton Down, London, United Kingdom
- Joint Modelling Team, UK Health Security Agency, London, United Kingdom
| | - Thomas J. R. Finnie
- Emergency Preparedness Response and Resilience Directorate, UK Health Security Agency, Porton Down, London, United Kingdom
- Joint Modelling Team, UK Health Security Agency, London, United Kingdom
| | - Emma Bennett
- Emergency Preparedness Response and Resilience Directorate, UK Health Security Agency, Porton Down, London, United Kingdom
- Joint Modelling Team, UK Health Security Agency, London, United Kingdom
| | - Paul Birrell
- Joint Modelling Team, UK Health Security Agency, London, United Kingdom
- MRC Biostatistics Unit, University of Cambridge, School of Clinical Medicine, Cambridge Institute of Public Health, Cambridge, United Kingdom
- Statistical Modelling and Economics, UK Health Security Agency, Colindale, United Kingdom
| | - Simon Kenny
- CYP Transformation Programme Team, Nursing Directorate, NHS England and NHS Improvement, Leeds, England
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
- Department of Paediatric Surgery, Alder Hey in the Park, Liverpool, United Kingdom
| | - Tiffany Watson-Koszel
- CYP Transformation Programme Team, Nursing Directorate, NHS England and NHS Improvement, Leeds, England
| | - Russell Viner
- Population, Policy and Practice, UCL Great Ormond St. Institute of Child Health, London, United Kingdom
| | - Moshe Arditi
- Department of Pediatrics, Division of Infectious Diseases and Immunology, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Daniela DeAngelis
- Statistical Modelling and Economics, UK Health Security Agency, Colindale, United Kingdom
| | - Nick Gent
- Emergency Preparedness Response and Resilience Directorate, UK Health Security Agency, Porton Down, London, United Kingdom
- Joint Modelling Team, UK Health Security Agency, London, United Kingdom
| | - Shamez N. Ladhani
- Immunisation and Countermeasures Division, UK Health Security Agency, London, United Kingdom
- Paediatric Infectious Diseases Research Group, St George’s University of London, London, United Kingdom
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