Risk Factors for Multisystem Inflammatory Syndrome in Children: A Case-control Investigation.

Autor:	Zambrano LD; From the COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia., Wu MJ; From the COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia., Martin L; Division of Infectious Disease, Department of Pediatrics, Children's of Mississippi, University of Mississippi Medical Center, Jackson, Mississippi., Malloch L; Division of Infectious Disease, Department of Pediatrics, Children's of Mississippi, University of Mississippi Medical Center, Jackson, Mississippi., Chen S; Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts., Newhams MM; Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts., Kucukak S; Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts., Son MB; Division of Immunology, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts.; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts., Sanders C; Division of Infectious Disease, Department of Pediatrics, Children's of Mississippi, University of Mississippi Medical Center, Jackson, Mississippi., Patterson K; Division of Infectious Disease, Department of Pediatrics, Children's of Mississippi, University of Mississippi Medical Center, Jackson, Mississippi., Halasa N; Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee., Fitzgerald JC; Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania., Leroue MK; Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, Aurora, Colorado., Hall M; Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Ohio., Irby K; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock, Arkansas., Rowan CM; Division of Pediatric Critical Care, Department of Pediatrics, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, Indiana., Wellnitz K; Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee., Sahni LC; Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas., Loftis L; Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas., Bradford TT; Division of Cardiology, Department of Pediatrics, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans, Louisiana., Staat M; Department of Pediatrics, University of Cincinnati College of Medicine, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio., Babbitt C; Miller Children's and Women's Hospital of Long Beach, Long Beach, California., Carroll CL; Division of Pediatric Critical Care, Connecticut Children's Hospital, Hartford, Connecticut., Pannaraj PS; Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee., Kong M; Department of Pediatrics, Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama., Schuster JE; Department of Pediatrics, Children's Mercy Kansas City, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri., Chou J; Division of Immunology, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts.; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts., Patel MM; From the COVID-19 Response Team, U.S. 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 Pediatrics, Harvard Medical School, Boston, Massachusetts.; Department of Anesthesia, Harvard Medical School, Boston, Massachusetts., Campbell AP; From the COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia., Hobbs CV; Division of Infectious Disease, Department of Pediatrics, Children's of Mississippi, University of Mississippi Medical Center, Jackson, Mississippi.
Jazyk:	angličtina
Zdroj:	The Pediatric infectious disease journal [Pediatr Infect Dis J] 2023 Jun 01; Vol. 42 (6), pp. e190-e196. Date of Electronic Publication: 2023 Mar 16.
DOI:	10.1097/INF.0000000000003900
Abstrakt:	Background: In a 2020 pilot case-control study using medical records, we reported that non-Hispanic Black children were more likely to develop multisystem inflammatory syndrome in children (MIS-C) after adjustment for sociodemographic factors and underlying medical conditions. Using structured interviews, we investigated patient, household, and community factors underlying MIS-C likelihood. Methods: MIS-C case patients hospitalized in 2021 across 14 US pediatric hospitals were matched by age and site to outpatient controls testing positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within 3 months of the admission date. Caregiver interviews queried race/ethnicity, medical history, and household and potential community exposures 1 month before MIS-C hospitalization (case-patients) or after SARS-CoV-2 infection (controls). We calculated adjusted odds ratios (aOR) using mixed-effects multivariable logistic regression. Results: Among 275 case patients and 496 controls, race/ethnicity, social vulnerability and patient or family history of autoimmune/rheumatologic disease were not associated with MIS-C. In previously healthy children, MIS-C was associated with a history of hospitalization for an infection [aOR: 4.8; 95% confidence interval (CI): 2.1-11.0]. Household crowding (aOR: 1.7; 95% CI: 1.2-2.6), large event attendance (aOR: 1.7; 95% CI: 1.3-2.1), school attendance with limited masking (aOR: 2.6; 95% CI: 1.1-6.6), public transit use (aOR: 1.8; 95% CI: 1.4-2.4) and co-resident testing positive for SARS-CoV-2 (aOR: 2.2; 95% CI: 1.3-3.7) were associated with increased MIS-C likelihood, with risk increasing with the number of these factors. Conclusions: From caregiver interviews, we clarify household and community exposures associated with MIS-C; however, we did not confirm prior associations between sociodemographic factors and MIS-C. (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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