Incidence of Multisystem Inflammatory Syndrome in Children Among US Persons Infected With SARS-CoV-2.

Autor:	Payne AB; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia., Gilani Z; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia., Godfred-Cato S; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia., Belay ED; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia., Feldstein LR; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia., Patel MM; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia., Randolph AG; Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts.; Department of Anesthesia and Pediatrics, Harvard Medical School, Boston, Massachusetts., Newhams M; Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts., Thomas D; New Jersey Department of Health, Trenton., Magleby R; New Jersey Department of Health, Trenton.; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia., Hsu K; Massachusetts Department of Health, Boston., Burns M; Massachusetts Department of Health, Boston., Dufort E; New York State Department of Health, Albany., Maxted A; New York State Department of Health, Albany., Pietrowski M; Philadelphia Department of Public Health, Philadelphia, Pennsylvania., Longenberger A; Pennsylvania Department of Health, Harrisburg., Bidol S; Michigan Department of Health and Human Services, Lansing., Henderson J; Enteric and Respiratory Illnesses Epidemiology Unit, Surveillance and Infectious Disease Epidemiology Section, Communicable Disease Division, Michigan Department of Health and Human Services, Lansing., Sosa L; Connecticut Department of Public Health, Hartford., Edmundson A; Connecticut Department of Public Health, Hartford.; Council of State and Territorial Epidemiologists, Atlanta, Georgia., Tobin-D'Angelo M; Acute Disease Epidemiology Section, Georgia Department of Public Health, Atlanta., Edison L; Acute Disease Epidemiology Section, Georgia Department of Public Health, Atlanta., Heidemann S; Department of Pediatrics, Division of Pediatric Critical Care Medicine, Central Michigan University, Detroit., Singh AR; Pediatric Critical Care Division, Maria Fareri Children's Hospital at Westchester Medical Center, Westchester, New York.; New York Medical College, Valhalla., Giuliano JS Jr; Department of Pediatrics, Division of Critical Care, Yale University School of Medicine, New Haven, Connecticut., Kleinman LC; Department of Pediatrics, Division of Population Health, Quality, and Implementation Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey., Tarquinio KM; Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia., Walsh RF; Department of Pediatrics, Division of Pediatric Cardiology, Children's Hospital of New Jersey, Newark Beth Israel, Newark., Fitzgerald JC; Division of Critical Care, Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia., Clouser KN; Division of Hospital Medicine, Department of Pediatrics, Hackensack University Medical Center, Hackensack, New Jersey., Gertz SJ; Division of Pediatric Critical Care, Department of Pediatrics, St Barnabas Medical Center, Livingston, New Jersey., Carroll RW; Division of Pediatric Critical Care Medicine, MassGeneral Hospital for Children, Harvard Medical School, Boston, Massachusetts., Carroll CL; Division of Critical Care, Connecticut Children's, Hartford., Hoots BE; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia., Reed C; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia., Dahlgren FS; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia., Oster ME; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia., Pierce TJ; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia., Curns AT; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia., Langley GE; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia., Campbell AP; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia., Balachandran N; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia., Murray TS; Department of Pediatrics, Infectious Disease and Global Health, Yale School of Medicine, New Haven, Connecticut., Burkholder C; Michigan Department of Health and Human Services, Lansing., Brancard T; New Jersey Department of Health, Trenton., Lifshitz J; New Jersey Department of Health, Trenton., Leach D; Massachusetts Department of Health, Boston., Charpie I; Massachusetts Department of Health, Boston., Tice C; New York State Department of Health, Albany., Coffin SE; Philadelphia Department of Public Health, Philadelphia, Pennsylvania., Perella D; Philadelphia Department of Public Health, Philadelphia, Pennsylvania., Jones K; Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia., Marohn KL; Baystate Children's Hospital, Springfield, Massachusetts., Yager PH; MassGeneral Hospital for Children, Harvard Medical School, Boston, Massachusetts., Fernandes ND; MassGeneral Hospital for Children, Harvard Medical School, Boston, Massachusetts., Flori HR; University of Michigan CS Mott Children's Hospital, Ann Arbor., Koncicki ML; St Christopher's Hospital for Children, Philadelphia, Pennsylvania., Walker KS; Cooper University Hospital, Camden, New Jersey., Di Pentima MC; Goryeb Children's Hospital, Morristown, New Jersey., Li S; Bristol-Myers Squibb Children's Hospital, New Brunswick, New Jersey., Horwitz SM; Bristol-Myers Squibb Children's Hospital, New Brunswick, New Jersey., Gaur S; Bristol-Myers Squibb Children's Hospital, New Brunswick, New Jersey., Coffey DC; The Valley Hospital, Ridgewood, New Jersey., Harwayne-Gidansky I; Stony Brook University Hospital, Stony Brook, New York., Hymes SR; Stony Brook University Hospital, Stony Brook, New York., Thomas NJ; Penn State Children's Hospital, Hershey, Pennsylvania., Ackerman KG; Golisano Children's Hospital, Rochester, New York., Cholette JM; Golisano Children's Hospital, Rochester, New York.
Jazyk:	angličtina
Zdroj:	JAMA network open [JAMA Netw Open] 2021 Jun 01; Vol. 4 (6), pp. e2116420. Date of Electronic Publication: 2021 Jun 01.
DOI:	10.1001/jamanetworkopen.2021.16420
Abstrakt:	Importance: Multisystem inflammatory syndrome in children (MIS-C) is associated with recent or current SARS-CoV-2 infection. Information on MIS-C incidence is limited. Objective: To estimate population-based MIS-C incidence per 1 000 000 person-months and to estimate MIS-C incidence per 1 000 000 SARS-CoV-2 infections in persons younger than 21 years. Design, Setting, and Participants: This cohort study used enhanced surveillance data to identify persons with MIS-C during April to June 2020, in 7 jurisdictions reporting to both the Centers for Disease Control and Prevention national surveillance and to Overcoming COVID-19, a multicenter MIS-C study. Denominators for population-based estimates were derived from census estimates; denominators for incidence per 1 000 000 SARS-CoV-2 infections were estimated by applying published age- and month-specific multipliers accounting for underdetection of reported COVID-19 case counts. Jurisdictions included Connecticut, Georgia, Massachusetts, Michigan, New Jersey, New York (excluding New York City), and Pennsylvania. Data analyses were conducted from August to December 2020. Exposures: Race/ethnicity, sex, and age group (ie, ≤5, 6-10, 11-15, and 16-20 years). Main Outcomes and Measures: Overall and stratum-specific adjusted estimated MIS-C incidence per 1 000 000 person-months and per 1 000 000 SARS-CoV-2 infections. Results: In the 7 jurisdictions examined, 248 persons with MIS-C were reported (median [interquartile range] age, 8 [4-13] years; 133 [53.6%] male; 96 persons [38.7%] were Hispanic or Latino; 75 persons [30.2%] were Black). The incidence of MIS-C per 1 000 000 person-months was 5.1 (95% CI, 4.5-5.8) persons. Compared with White persons, incidence per 1 000 000 person-months was higher among Black persons (adjusted incidence rate ratio [aIRR], 9.26 [95% CI, 6.15-13.93]), Hispanic or Latino persons (aIRR, 8.92 [95% CI, 6.00-13.26]), and Asian or Pacific Islander (aIRR, 2.94 [95% CI, 1.49-5.82]) persons. MIS-C incidence per 1 000 000 SARS-CoV-2 infections was 316 (95% CI, 278-357) persons and was higher among Black (aIRR, 5.62 [95% CI, 3.68-8.60]), Hispanic or Latino (aIRR, 4.26 [95% CI, 2.85-6.38]), and Asian or Pacific Islander persons (aIRR, 2.88 [95% CI, 1.42-5.83]) compared with White persons. For both analyses, incidence was highest among children aged 5 years or younger (4.9 [95% CI, 3.7-6.6] children per 1 000 000 person-months) and children aged 6 to 10 years (6.3 [95% CI, 4.8-8.3] children per 1 000 000 person-months). Conclusions and Relevance: In this cohort study, MIS-C was a rare complication associated with SARS-CoV-2 infection. Estimates for population-based incidence and incidence among persons with infection were higher among Black, Hispanic or Latino, and Asian or Pacific Islander persons. Further study is needed to understand variability by race/ethnicity and age group.
Databáze:	MEDLINE
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