High incidence of multisystem inflammatory syndrome and other autoimmune diseases after SARS-CoV-2 infection compared to COVID-19 vaccination in children and adolescents in south central Europe.

Autor:	Bizjak M; Department of Allergology, Rheumatology and Clinical Immunology, Children's Hospital, University Medical Centre Ljubljana, Slovenia., Emeršič N; Department of Allergology, Rheumatology and Clinical Immunology, Children's Hospital, University Medical Centre Ljubljana, Slovenia., Zajc Avramovič M; Department of Allergology, Rheumatology and Clinical Immunology, Children's Hospital, University Medical Centre Ljubljana, Slovenia., Barbone F; Department of Medicine (DAME), University of Udine, Italy., Ronchese F; Clinical Unit of Occupational Medicine, Department of Medical Sciences, University of Trieste, Italy., Della Paolera S; Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy., Conversano E; Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy., Amoroso S; Department of Paediatrics, Azienda per l'Assistenza sanitaria n 5 Friuli Occidentale, Pordenone, Italy., Vidoni M; Department of Medical Sciences, University of Udine, Italy., Vesel Tajnšek T; Department of Allergology, Rheumatology and Clinical Immunology, Children's Hospital, University Medical Centre Ljubljana, Slovenia., Mlakar G; Department of Cardiology, Children's Hospital, University Medical Centre Ljubljana, Slovenia., Berce V; Division of Paediatrics, University Medical Centre Maribor, Slovenia., Markelj G; Department of Allergology, Rheumatology and Clinical Immunology, Children's Hospital, University Medical Centre Ljubljana, Slovenia., Plankar Srovin T; Department of Infectious Diseases, University Medical Centre Ljubljana, Slovenia., Golli T; Department of Child, Adolescent and Developmental Neurology, Children's Hospital, University Medical Centre Ljubljana, and Department of Paediatrics, Faculty of Medicine, University of Ljubljana, Slovenia., Osredkar D; Department of Child, Adolescent and Developmental Neurology, Children's Hospital, University Medical Centre Ljubljana, and Department of Paediatrics, Faculty of Medicine, University of Ljubljana, Slovenia., Koren Jeverica A; Department of Allergology, Rheumatology and Clinical Immunology, Children's Hospital, University Medical Centre Ljubljana, Slovenia., Toplak N; Department of Allergology, Rheumatology and Clinical Immunology, Children's Hospital, University Medical Centre Ljubljana, and Department of Paediatrics, Faculty of Medicine, University of Ljubljana, Slovenia., Pokorn M; Department of Pediatrics, Faculty of Medicine, University of Ljubljana, and Children's Hospital, University Medical Centre Ljubljana, Slovenia., Avšič Županc T; Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Slovenia., Ihan A; Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Slovenia., Fafangel M; Communicable Diseases Centre, National Institute of Public Health, Ljubljana, Slovenia., Taddio A; Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, and University of Trieste, Italy., Avčin T; Department of Allergology, Rheumatology and Clinical Immunology, Children's Hospital, University Medical Centre Ljubljana, and Department of Paediatrics, Faculty of Medicine, University of Ljubljana, Slovenia. tadej.avcin@kclj.si.
Jazyk:	angličtina
Zdroj:	Clinical and experimental rheumatology [Clin Exp Rheumatol] 2023 May; Vol. 41 (5), pp. 1183-1191. Date of Electronic Publication: 2022 Nov 12.
DOI:	10.55563/clinexprheumatol/i1l2xn
Abstrakt:	Objectives: To estimate the incidence and describe the spectrum of inflammatory and autoimmune diseases linked to SARS-CoV-2 infection and COVID-19 vaccination in children from two neighbouring south central European countries. Methods: We performed a multi-centre prospective cohort study of children under 18 years diagnosed with inflammatory/autoimmune diseases linked to SARS-CoV-2 infection or COVID-19 vaccination, who were admitted to the paediatric tertiary care hospitals in Slovenia and Friuli Venezia Giulia, Italy, from January 1, 2020, to December 31, 2021. Disease incidence was calculated based on laboratory-confirmed cases only. Results: Inflammatory and autoimmune diseases linked to SARS-CoV-2 were diagnosed in 192 children (127 laboratory-confirmed), of whom 112 had multisystem inflammatory syndrome (MIS-C), followed by vasculitis, neurological and cardiac diseases. Calculated risk of MIS-C was 1 in 860 children after SARS-CoV-2 infection and cumulative incidence of MIS-C was 18.3/100,000 of all children. Fifteen children had severe COVID-19. Two patients with MIS-C and a patient with myositis presented after COVID-19 vaccination. All 3 had at presentation also a serologically proven recent SARS-CoV-2 infection. After MIS-C, nine patients were vaccinated against COVID-19 and 25 patients had a SARS-CoV-2 reinfection, without recurrence of MIS-C. Conclusions: Autoimmune diseases following SARS-CoV-2 infection in children were 8.5 times as common as severe COVID-19. MIS-C was the most common manifestation and its incidence in this predominantly white population was higher than previously reported. MIS-C does not seem to recur after SARS-CoV-2 reinfection or COVID-19 vaccination. Autoimmune diseases were much more common after SARS-CoV-2 infection than after COVID-19 vaccination.
Databáze:	MEDLINE
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