Multisystem Inflammatory Syndrome in Children—United States, February 2020

Multisystem Inflammatory Syndrome in Children—United States, February 2020–July 2021

Published:2021-12-05 Issue: Volume: Page:
ISSN:1058-4838
Container-title:Clinical Infectious Diseases
language:en
Short-container-title:

Author:

Miller Allison D¹,Zambrano Laura D¹,Yousaf Anna R¹,Abrams Joseph Y¹,Meng Lu¹,Wu Michael J¹,Melgar Michael¹,Oster Matthew E¹,Godfred Cato Shana E¹,Belay Ermias D¹,Campbell Angela P¹,Anyalechi Gloria E²,Bowen Anna²,Do Tuyen²,Gastañaduy Paul A²,Lindsey Katherine²,St. Cyr Sancta B²,Kaur Ramandeep³,Pompa Xandy Peterson⁴,Le Marchand Chloe E⁵,Singson Jason Robert C⁵⁶,O’Brien Shannon C⁷,Schmitz Ann M⁸⁹,Torres Díaz Carola I⁸,Elbedewy Walaa M¹⁰,Tobin-D’Angelo Melissa J¹⁰,Reid Heather D¹¹,Fricchione Marielle J¹²,Hallyburton Sara J¹³,Richardson Gillian¹⁴,Hand Julie P¹⁴,Leach Dylan H¹⁵,Burkholder Cole P¹⁶,Lim Sarah¹⁷,Thomas Deepam¹⁸,Gowie Donna L¹⁹,Dufort Elizabeth M¹⁹,Lee Ellen H²⁰,Falodun Ayotola A²¹,Dewart Courtney M²²²³,Colles Zachary J²²,Wallace Jennifer L²⁴,Johnson LaKita D²⁵,Herring Kristina L²⁶,Liptack Andrea R²⁷²⁸,

Affiliation:

1. CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA

2. CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA

3. Alabama Department of Public Health, Montgomery, Alabama, USA

4. Arizona Department of Health Services, Phoenix, Arizona, USA

5. California Department of Health, Richmond, California, USA

6. Council of State and Territorial Epidemiologists, Atlanta, Georgia, USA

7. Colorado Department of Public Health and Environment, Denver, Colorado, USA

8. Florida Department of Health, Tallahassee, Florida, USA

9. Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA

10. Georgia Department of Public Health, Atlanta, GA, USA

11. Illinois Department of Public Health, Springfield, IL, USA

12. Chicago Department of Public Health, Chicago, Illinois, USA

13. Indiana Department of Health, Indianapolis, Indiana, USA

14. Louisiana Department of Health, New Orleans, Louisiana, USA

15. Massachusetts Department of Public Health, Boston, Massachusetts, USA

16. Michigan Department of Health and Human Services, Lansing, Michigan, USA

17. Minnesota Department of Health, St Paul, Minnesota, USA

18. New Jersey Department of Health, Trenton, New Jersey, USA

19. New York State Department of Health, Albany, New York, USA

20. New York City Department of Health and Mental Hygiene, Long Island, New York, USA

21. North Carolina Department of Health and Human Services, Raleigh, NC, USA

22. Ohio Department of Health, Columbus, Ohio, USA

23. Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA

24. Pennsylvania Department of Health, Harrisburg, Pennsylvania, USA

25. South Carolina Department of Health and Environmental Control, Columbia, South Carolina, USA

26. Tennessee Department of Health, Nashville, Tennessee, USA

27. Wisconsin Department of Health Services, Madison, Wisconsin, USA

28. CDC Foundation, Atlanta, Georgia, USA

Abstract

Abstract Background Multisystem inflammatory syndrome in children (MIS-C) is a severe hyperinflammatory condition in persons aged <21 years associated with antecedent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Our objective was to describe MIS-C cases reported to Centers for Disease Control and Prevention’s (CDC’s) national surveillance since the coronavirus disease 2019 (COVID-19) pandemic began. Methods We included patients meeting the MIS-C case definition with onset date from 19 February 2020 through 31 July 2021, using CDC’s MIS-C case report form, which collects information on demographics, clinical presentation, and laboratory results. Trends over time across 3 MIS-C pandemic waves were assessed using Cochran-Armitage test for categorical and Jonckheere-Terpstra test for continuous variables. Results Of 4901 reported cases, 4470 met inclusion criteria. Median patient age increased over time (P < .001), with a median of 9 years (interquartile range, 5–13 years) during the most recent (third) wave. Male predominance also increased (62% in third wave, P < .001). A significant (P < .001) increase in severe hematologic and gastrointestinal involvement was observed across the study period. Frequency of several cardiovascular complications (ie, cardiac dysfunction, myocarditis, and shock/vasopressor receipt) and renal failure declined (P < .001). Provision of critical care including mechanical ventilation (P < .001) and extracorporeal membrane oxygenation (ECMO; P = .046) decreased, as did duration of hospitalization and mortality (each P < .001). Conclusions Over the first 3 pandemic waves of MIS-C in the United States, cardiovascular complications and clinical outcomes including length of hospitalization, receipt of ECMO, and death decreased over time. These data serve as a baseline for monitoring future trends associated with SARS-CoV-2 B.1.617.2 (Delta) or other variants and increased COVID-19 vaccination among children.

Funder

Centers for Disease Control and Prevention

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Microbiology (medical)

Link

https://academic.oup.com/cid/advance-article-pdf/doi/10.1093/cid/ciab1007/42163385/ciab1007.pdf

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