Multisystem inflammatory syndrome in children and SARS-CoV-2 variants: a two-year ambispective multicentric cohort study in Catalonia, Spain.

Multisystem inflammatory syndrome in children (MIS-C) is a rare but severe disease temporarily related to SARS-CoV-2. We aimed to describe the epidemiological, clinical, and laboratory findings of all MIS-C cases diagnosed in children < 18 years old in Catalonia (Spain) to study their trend throughout the pandemic. This was a multicenter ambispective observational cohort study (April 2020-April 2022). Data were obtained from the COVID-19 Catalan surveillance system and from all hospitals in Catalonia. We analyzed MIS-C cases regarding SARS-CoV-2 variants for demographics, symptoms, severity, monthly MIS-C incidence, ratio between MIS-C and accumulated COVID-19 cases, and associated rate ratios (RR). Among 555,848 SARS-CoV-2 infections, 152 children were diagnosed with MIS-C. The monthly MIS-C incidence was 4.1 (95% CI: 3.4-4.8) per 1,000,000 people, and 273 (95% CI: 230-316) per 1,000,000 SARS-CoV-2 infections (i.e., one case per 3,700 SARS-CoV-2 infections). During the Omicron period, the MIS-C RR was 8.2 (95% CI: 5.7-11.7) per 1,000,000 SARS-CoV-2 infections, which was significantly lower (p < 0.001) than that for previous variant periods in all age groups. The median [IQR] age of MIS-C was 8 [4-11] years, 62.5% male, and 80.2% without comorbidities. Common symptoms were gastrointestinal findings (88.2%) and fever > 39 °C (81.6%); nearly 40% had an abnormal echocardiography, and 7% had coronary aneurysm. Clinical manifestations and laboratory data were not different throughout the variant periods (p > 0.05).  Conclusion: The RR between MIS-C cases and SARS-CoV-2 infections was significantly lower in the Omicron period for all age groups, including those not vaccinated, suggesting that the variant could be the main factor for this shift in the MISC trend. Regardless of variant type, the patients had similar phenotypes and severity throughout the pandemic. What is Known: • Before our study, only two publications investigated the incidence of MIS-C regarding SARS-CoV-2 variants in Europe, one from Southeast England and another from Denmark. What is New: • To our knowledge, this is the first study investigating MIS-C incidence in Southern Europe, with the ability to recruit all MIS-C cases in a determined area and analyze the rate ratio for MIS-C among SARS-CoV-2 infections throughout variant periods. • We found a lower rate ratio of MISC/infections with SARS-CoV-2 in the Omicron period for all age groups, including those not eligible for vaccination, suggesting that the variant could be the main factor for this shift in the MISC trend.

Influence of COVID-19 on the Perception of Academic Self-Efficacy, State Anxiety, and Trait Anxiety in College Students.

The worldwide pandemic situation caused by coronavirus disease 2019 (COVID-19) has led to a state of confinement of the population, which has caused, following consulted research, an increase in stress. Faced with this situation, the Spanish university not only had to adapt to the changes derived from the causes of the pandemic but also had to face a new methodological model-e-learning teaching-for which not all teachers and students were prepared. This could cause an increase in stress due to the uncertainty caused by this time of change. This research analyzes the relationship between perceived self-efficacy in the confinement period and the level of trait anxiety (TA) and state anxiety (SA) during COVID-19. Four hundred twenty-seven students from the University of Granada (Spain) participated in this study. The adaptation of two scales that measure perceived academic self-efficacy and anxiety (TA and SA) has been applied. The results indicated that there was an inversely proportional relationship between anxiety and self-efficacy; men showed the highest perception of self-efficacy, while women had higher scores in TA and SA; the latter was accentuated in cases when a relative died. To conclude, students who show a higher level of anxiety (TA and SA) express more negative emotions and also perceive themselves with less academic self-efficacy. Therefore, a stressful situation (pandemic and confinement) together with a critical event (illness and death of a relative/friend due to COVID-19) increases anxiety levels and influences the perception of academic self-efficacy.