Contributors: Pino R Paediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Spain. Antoñanzas JM, Perramon A Department of Physics, Universitat Politècnica de Catalunya, Barcelona, Spain. Paredes-Carmona F Hospital Universitari Arnau de Vilanova, Lleida, Spain. Rivière JG Paediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain. Coma M Hospital Universitari Joan XXII, Tarragona, Spain. Martínez-Mejías A, Esquirol-Herrero C Servei de Pediatria, Hospital de Terrassa, Consorci Sanitari de Terrassa, Terrassa, Spain; Consorci Sanitari de Terrassa
Abstract: Coronavirus infections; Epidemiology; Severity of illness index ; Infecciones por Coronavirus; Epidemiología; Índice de la gravedad de la enfermedad ; Infeccions per coronavirus; Epidemiologia; Índex de la gravetat de la malaltia ; 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 ...
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