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Multisystem Inflammatory Syndrome in Children-United States, February 2020-July 2021.
Miller, Allison D; Zambrano, Laura D; Yousaf, Anna R; Abrams, Joseph Y; Meng, Lu; Wu, Michael J; Melgar, Michael; Oster, Matthew E; Godfred Cato, Shana E; Belay, Ermias D; Campbell, Angela P.
  • Miller AD; CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA.
  • Zambrano LD; CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA.
  • Yousaf AR; CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA.
  • Meng L; CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA.
  • Wu MJ; CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA.
  • Melgar M; CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA.
  • Oster ME; CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA.
  • Godfred Cato SE; CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA.
  • Belay ED; CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA.
  • Campbell AP; CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Clin Infect Dis ; 2021 Dec 05.
Article in English | MEDLINE | ID: covidwho-1550541
ABSTRACT

BACKGROUND:

Multisystem inflammatory syndrome in children (MIS-C) is a severe hyperinflammatory condition in persons aged <21 years associated with antecedent SARS-CoV-2 infection. Our objective was to describe MIS-C cases reported to CDC's national surveillance since the COVID-19 pandemic began.

METHODS:

We included patients meeting the MIS-C case definition with onset date from February 19, 2020 through July 31, 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 4,901 reported cases, 4,470 met inclusion criteria. Median patient age increased over time (P<0.001), 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<0.001). A significant (P<0.001) increase in severe hematologic and gastrointestinal involvement was observed across the study period. Frequency of several cardiovascular complications (i.e., cardiac dysfunction, myocarditis, and shock/ vasopressor receipt) and renal failure declined (P<0.001). Provision of critical care including mechanical ventilation (P<0.001) and extracorporeal membrane oxygenation (ECMO; P=0.046) decreased, as did duration of hospitalization and mortality (each P<0.001).

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.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study Topics: Vaccines / Variants Language: English Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: Cid

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study Topics: Vaccines / Variants Language: English Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: Cid