tetano
Editor, Senior Moderator
Pediatr Infect Dis J
. 2023 Mar 16.
doi: 10.1097/INF.0000000000003900. Online ahead of print.
Risk Factors for Multisystem Inflammatory Syndrome in Children: A Case-Control Investigation
Laura D Zambrano[SUP] 1 [/SUP], Michael J Wu[SUP] 1 [/SUP], Lora Martin[SUP] 2 [/SUP], Lacy Malloch[SUP] 2 [/SUP], Sabrina Chen[SUP] 3 [/SUP], Margaret M Newhams[SUP] 3 [/SUP], Mary Beth Son[SUP] 4 5 [/SUP], Cameron Sanders[SUP] 2 [/SUP], Kayla Patterson[SUP] 2 [/SUP], Natasha Halasa[SUP] 6 [/SUP], Julie Fitzgerald[SUP] 7 [/SUP], Matthew Leroue[SUP] 8 [/SUP], Mark Hall[SUP] 9 [/SUP], Katherine Irby[SUP] 10 [/SUP], Courtney M Rowan[SUP] 11 [/SUP], Kari Wellnitz[SUP] 12 [/SUP], Leila Sahni[SUP] 13 [/SUP], Laura Loftis[SUP] 13 [/SUP], Tamara T Bradford[SUP] 14 [/SUP], Mary Staat[SUP] 15 [/SUP], Christopher Babbitt[SUP] 16 [/SUP], Christopher L Carroll[SUP] 17 [/SUP], Pia Pannaraj[SUP] 18 [/SUP], Michele Kong[SUP] 19 [/SUP], Jennifer E Schuster[SUP] 20 [/SUP], Janet Chou[SUP] 4 5 [/SUP], Manish M Patel[SUP] 1 [/SUP], Adrienne G Randolph[SUP] 3 5 21 [/SUP], Angela P Campbell[SUP] 1 [/SUP], Charlotte V Hobbs[SUP] 2 [/SUP]; Overcoming COVID-19 investigators
Affiliations
Abstract
Background: In a 2020 pilot case-control study using medical records, we reported that non-Hispanic Black children were more likely to develop multisystem inflammatory syndrome in children (MIS-C) after adjustment for sociodemographic factors and underlying medical conditions. Using structured interviews, we investigated patient, household, and community factors underlying MIS-C likelihood.
Methods: MIS-C case patients hospitalized in 2021 across 14 US pediatric hospitals were matched by age and site to outpatient controls testing positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within 3 months of the admission date. Caregiver interviews queried race/ethnicity, medical history, and household and potential community exposures 1 month before MIS-C hospitalization (case-patients) or after SARS-CoV-2 infection (controls). We calculated adjusted odds ratios (aOR) using mixed-effects multivariable logistic regression.
Results: Among 275 case patients and 496 controls, race/ethnicity, social vulnerability and patient or family history of autoimmune/rheumatologic disease were not associated with MIS-C. In previously healthy children, MIS-C was associated with a history of hospitalization for an infection [aOR: 4.8; 95% confidence interval (CI): 2.1-11.0]. Household crowding (aOR: 1.7; 95% CI: 1.2-2.6), large event attendance (aOR: 1.7; 95% CI: 1.3-2.1), school attendance with limited masking (aOR: 2.6; 95% CI: 1.1-6.6), public transit use (aOR: 1.8; 95% CI: 1.4-2.4) and co-resident testing positive for SARS-CoV-2 (aOR: 2.2; 95% CI: 1.3-3.7) were associated with increased MIS-C likelihood, with risk increasing with the number of these factors.
Conclusions: From caregiver interviews, we clarify household and community exposures associated with MIS-C; however, we did not confirm prior associations between sociodemographic factors and MIS-C.
. 2023 Mar 16.
doi: 10.1097/INF.0000000000003900. Online ahead of print.
Risk Factors for Multisystem Inflammatory Syndrome in Children: A Case-Control Investigation
Laura D Zambrano[SUP] 1 [/SUP], Michael J Wu[SUP] 1 [/SUP], Lora Martin[SUP] 2 [/SUP], Lacy Malloch[SUP] 2 [/SUP], Sabrina Chen[SUP] 3 [/SUP], Margaret M Newhams[SUP] 3 [/SUP], Mary Beth Son[SUP] 4 5 [/SUP], Cameron Sanders[SUP] 2 [/SUP], Kayla Patterson[SUP] 2 [/SUP], Natasha Halasa[SUP] 6 [/SUP], Julie Fitzgerald[SUP] 7 [/SUP], Matthew Leroue[SUP] 8 [/SUP], Mark Hall[SUP] 9 [/SUP], Katherine Irby[SUP] 10 [/SUP], Courtney M Rowan[SUP] 11 [/SUP], Kari Wellnitz[SUP] 12 [/SUP], Leila Sahni[SUP] 13 [/SUP], Laura Loftis[SUP] 13 [/SUP], Tamara T Bradford[SUP] 14 [/SUP], Mary Staat[SUP] 15 [/SUP], Christopher Babbitt[SUP] 16 [/SUP], Christopher L Carroll[SUP] 17 [/SUP], Pia Pannaraj[SUP] 18 [/SUP], Michele Kong[SUP] 19 [/SUP], Jennifer E Schuster[SUP] 20 [/SUP], Janet Chou[SUP] 4 5 [/SUP], Manish M Patel[SUP] 1 [/SUP], Adrienne G Randolph[SUP] 3 5 21 [/SUP], Angela P Campbell[SUP] 1 [/SUP], Charlotte V Hobbs[SUP] 2 [/SUP]; Overcoming COVID-19 investigators
Affiliations
- PMID: 37000922
- DOI: 10.1097/INF.0000000000003900
Abstract
Background: In a 2020 pilot case-control study using medical records, we reported that non-Hispanic Black children were more likely to develop multisystem inflammatory syndrome in children (MIS-C) after adjustment for sociodemographic factors and underlying medical conditions. Using structured interviews, we investigated patient, household, and community factors underlying MIS-C likelihood.
Methods: MIS-C case patients hospitalized in 2021 across 14 US pediatric hospitals were matched by age and site to outpatient controls testing positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within 3 months of the admission date. Caregiver interviews queried race/ethnicity, medical history, and household and potential community exposures 1 month before MIS-C hospitalization (case-patients) or after SARS-CoV-2 infection (controls). We calculated adjusted odds ratios (aOR) using mixed-effects multivariable logistic regression.
Results: Among 275 case patients and 496 controls, race/ethnicity, social vulnerability and patient or family history of autoimmune/rheumatologic disease were not associated with MIS-C. In previously healthy children, MIS-C was associated with a history of hospitalization for an infection [aOR: 4.8; 95% confidence interval (CI): 2.1-11.0]. Household crowding (aOR: 1.7; 95% CI: 1.2-2.6), large event attendance (aOR: 1.7; 95% CI: 1.3-2.1), school attendance with limited masking (aOR: 2.6; 95% CI: 1.1-6.6), public transit use (aOR: 1.8; 95% CI: 1.4-2.4) and co-resident testing positive for SARS-CoV-2 (aOR: 2.2; 95% CI: 1.3-3.7) were associated with increased MIS-C likelihood, with risk increasing with the number of these factors.
Conclusions: From caregiver interviews, we clarify household and community exposures associated with MIS-C; however, we did not confirm prior associations between sociodemographic factors and MIS-C.