tetano
Editor, Senior Moderator
Pediatr Infect Dis J
. 2026 May 14.
doi: 10.1097/INF.0000000000005278. Online ahead of print.
SARS-CoV-2 Reinfection and Risk of Multisystem Inflammatory Syndrome in Children: A Case-Control Study
Noémie Schiever[SUP] 1 [/SUP], Léa Lenglart[SUP] 2 3 [/SUP], Corinne Levy[SUP] 4 5 6 [/SUP], Pierre-Alex Crisinel[SUP] 7 [/SUP], Arnaud G L'Huillier[SUP] 8 [/SUP], Johan N Siebert[SUP] 9 [/SUP], Margherita Plebani[SUP] 7 [/SUP], Yves Fougere[SUP] 7 [/SUP], Alain Lefevre-Utile[SUP] 7 [/SUP], Alexis Rybak[SUP] 7 10 [/SUP], Eloise Burdet[SUP] 7 [/SUP], Axelle Dupont[SUP] 11 [/SUP], Olivier Brissaud[SUP] 6 12 [/SUP], Jeanne Bordet[SUP] 13 [/SUP], Lucas Percheron[SUP] 14 [/SUP], Camille Brehin[SUP] 15 [/SUP], Noémie Vanel[SUP] 10 [/SUP], Caroline Ovaert[SUP] 16 17 18 19 [/SUP], Alexandre Belot[SUP] 20 21 [/SUP], Aurélie Morand[SUP] 22 [/SUP], Julie Toubiana[SUP] 23 24 [/SUP], Marion Grimaud[SUP] 6 12 17 18 [/SUP], Stéphane Dauger[SUP] 25 [/SUP], Julien Baleine[SUP] 26 [/SUP], Stéphane Bechet[SUP] 4 [/SUP], Alain Burtscher[SUP] 27 [/SUP], Alain Wollner[SUP] 27 [/SUP], Robert Cohen[SUP] 4 6 28 [/SUP], Pierre-Louis Leger[SUP] 29 [/SUP], Caroline Galeotti[SUP] 30 [/SUP], Romain Basmaci[SUP] 3 6 12 17 18 19 [/SUP], Camille Aupiais[SUP] 3 25 [/SUP], Naïm Ouldali[SUP] 3 5 28 [/SUP], François Angoulvant[SUP] 7 [/SUP]
Affiliations
Background: Multisystem inflammatory syndrome in children (MIS-C) is a severe postinfectious complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, primarily affecting children aged 6-12 years. Although MIS-C was prominent during the early pandemic waves, recent studies suggest a declining incidence concurrent with increasing reinfection rates. The objective was to determine whether the risk of MIS-C differs following a primary SARS-CoV-2 infection versus reinfection.
Methods: A retrospective, multicenter, international, matched case-control study was conducted from September 1, 2021, to April 30, 2022. MIS-C cases were recruited from 14 French and Swiss hospitals. Eligible cases included children younger than 18 years meeting the 2020 World Health Organization case MIS-C definition with laboratory evidence of SARS-CoV-2 infection. Cases were matched 1:1 by age, sex and epidemic period to controls with laboratory-confirmed acute SARS-CoV-2 infection. Vaccinated patients and those without consent were excluded. The primary outcome compared the association of reinfection with MIS-C versus acute infection using McNemar's test to estimate matched odds ratios (ORs). Prespecified sensitivity analyses used conditional logistic regression.
Results: The matched cohort included 180 MIS-C cases (median [IQR] age, 106 [62-136] months) and 180 controls (median [interquartile range] age, 72 [48-108] months). No MIS-C cases had a documented reinfection, whereas 3.9% (7/180) of controls did (McNemar χ2 = 5.142; P = 0.023; matched OR, 0.067; 95% confidence interval [0.004-1.167]; P = 0.064). Sensitivity analysis also suggested a lower odds of MIS-C after reinfection without reaching statistical significance (adjusted OR, 0.183; 95% [0.027-1.234]; P = 0.093).
Conclusion: MIS-C occurred predominantly after first SARS-CoV-2 infections; while evidence for a lower risk following reinfection was suggestive but not conclusive.
Keywords: COVID- 19-related; PIMS- TS; SARS-CoV- 2; pediatric multisystem inflammatory disease; pediatrics.
. 2026 May 14.
doi: 10.1097/INF.0000000000005278. Online ahead of print.
SARS-CoV-2 Reinfection and Risk of Multisystem Inflammatory Syndrome in Children: A Case-Control Study
Noémie Schiever[SUP] 1 [/SUP], Léa Lenglart[SUP] 2 3 [/SUP], Corinne Levy[SUP] 4 5 6 [/SUP], Pierre-Alex Crisinel[SUP] 7 [/SUP], Arnaud G L'Huillier[SUP] 8 [/SUP], Johan N Siebert[SUP] 9 [/SUP], Margherita Plebani[SUP] 7 [/SUP], Yves Fougere[SUP] 7 [/SUP], Alain Lefevre-Utile[SUP] 7 [/SUP], Alexis Rybak[SUP] 7 10 [/SUP], Eloise Burdet[SUP] 7 [/SUP], Axelle Dupont[SUP] 11 [/SUP], Olivier Brissaud[SUP] 6 12 [/SUP], Jeanne Bordet[SUP] 13 [/SUP], Lucas Percheron[SUP] 14 [/SUP], Camille Brehin[SUP] 15 [/SUP], Noémie Vanel[SUP] 10 [/SUP], Caroline Ovaert[SUP] 16 17 18 19 [/SUP], Alexandre Belot[SUP] 20 21 [/SUP], Aurélie Morand[SUP] 22 [/SUP], Julie Toubiana[SUP] 23 24 [/SUP], Marion Grimaud[SUP] 6 12 17 18 [/SUP], Stéphane Dauger[SUP] 25 [/SUP], Julien Baleine[SUP] 26 [/SUP], Stéphane Bechet[SUP] 4 [/SUP], Alain Burtscher[SUP] 27 [/SUP], Alain Wollner[SUP] 27 [/SUP], Robert Cohen[SUP] 4 6 28 [/SUP], Pierre-Louis Leger[SUP] 29 [/SUP], Caroline Galeotti[SUP] 30 [/SUP], Romain Basmaci[SUP] 3 6 12 17 18 19 [/SUP], Camille Aupiais[SUP] 3 25 [/SUP], Naïm Ouldali[SUP] 3 5 28 [/SUP], François Angoulvant[SUP] 7 [/SUP]
Affiliations
- PMID: 42157330
- DOI: 10.1097/INF.0000000000005278
Background: Multisystem inflammatory syndrome in children (MIS-C) is a severe postinfectious complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, primarily affecting children aged 6-12 years. Although MIS-C was prominent during the early pandemic waves, recent studies suggest a declining incidence concurrent with increasing reinfection rates. The objective was to determine whether the risk of MIS-C differs following a primary SARS-CoV-2 infection versus reinfection.
Methods: A retrospective, multicenter, international, matched case-control study was conducted from September 1, 2021, to April 30, 2022. MIS-C cases were recruited from 14 French and Swiss hospitals. Eligible cases included children younger than 18 years meeting the 2020 World Health Organization case MIS-C definition with laboratory evidence of SARS-CoV-2 infection. Cases were matched 1:1 by age, sex and epidemic period to controls with laboratory-confirmed acute SARS-CoV-2 infection. Vaccinated patients and those without consent were excluded. The primary outcome compared the association of reinfection with MIS-C versus acute infection using McNemar's test to estimate matched odds ratios (ORs). Prespecified sensitivity analyses used conditional logistic regression.
Results: The matched cohort included 180 MIS-C cases (median [IQR] age, 106 [62-136] months) and 180 controls (median [interquartile range] age, 72 [48-108] months). No MIS-C cases had a documented reinfection, whereas 3.9% (7/180) of controls did (McNemar χ2 = 5.142; P = 0.023; matched OR, 0.067; 95% confidence interval [0.004-1.167]; P = 0.064). Sensitivity analysis also suggested a lower odds of MIS-C after reinfection without reaching statistical significance (adjusted OR, 0.183; 95% [0.027-1.234]; P = 0.093).
Conclusion: MIS-C occurred predominantly after first SARS-CoV-2 infections; while evidence for a lower risk following reinfection was suggestive but not conclusive.
Keywords: COVID- 19-related; PIMS- TS; SARS-CoV- 2; pediatric multisystem inflammatory disease; pediatrics.