Nationwide Survey of Multisystem Inflammatory Syndrome in Children Associated with Coronavirus Disease 2019 in Japan.

Autor: Matsubara D; Department of Pediatrics, Jichi Medical University, 3311-1 Shimotsuke, Tochigi, 329-0498, Japan. 99081dm@jichi.ac.jp., Matsubara Y; Division of Public Health, Center for Community Medicine, Jichi Medical University, Tochigi, Japan., Ayusawa M; Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan., Hamada H; Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan., Seki M; Department of Pediatrics, Jichi Medical University, 3311-1 Shimotsuke, Tochigi, 329-0498, Japan., Yamagishi H; Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan., Mitani Y; Department of Pediatrics, Mie University Graduate School of Medicine, Mie, Japan., Onouchi Y; Department of Public Health, Chiba University Graduate School of Medicine, Chiba, Japan., Moriuchi H; Department of Pediatrics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan., Miyairi I; Department of Pediatrics, Hamamatsu University School of Medicine, Shizuoka, Japan., Tanaka-Taya K; Kanagawa Prefectural Institute of Public Health, Kanagawa, Japan., Katsuta T; Department of Pediatrics, St. Marianna University School of Medicine, Kanagawa, Japan., Kurosawa H; Department of Pediatric Critical Care Medicine, Hyogo Prefectural Kobe Children's Hospital, Hyogo, Japan., Aoki K; Department of Pediatric Critical Care Medicine, Hyogo Prefectural Kobe Children's Hospital, Hyogo, Japan., Shimizu N; Department of Pediatrics, St. Marianna University School of Medicine, Kanagawa, Japan., Nakamura Y; Utsunomiya Public Health Center, Tochigi, Japan.
Jazyk: angličtina
Zdroj: Journal of clinical immunology [J Clin Immunol] 2024 Nov 30; Vol. 45 (1), pp. 51. Date of Electronic Publication: 2024 Nov 30.
DOI: 10.1007/s10875-024-01845-z
Abstrakt: Background: Multisystem inflammatory syndrome in children (MIS-C) presents some clinical overlap with Kawasaki disease (KD). Although KD is common in Japan, the clinical characteristics of MIS-C in Japan remain unknown. Therefore, we aimed to determine the epidemiological and clinical features of MIS-C in Japan.
Methods: Using a case reporting form, a nationwide registry was created between November 2020 and March 2023, involving 2,080 facilities throughout Japan. We prospectively and retrospectively enrolled patients with MIS-C. The primary outcomes were the number and incidence rates of children with MIS-C. The secondary outcomes included clinical features, such as KD phenotype, organ involvement, shock, intensive care unit admission, and coronary artery lesions.
Results: Among 398 patients registered, central review identified 129 MIS-C cases (mean age: 8·8 ± 3·7 years). The overall incidence rate was estimated to be 1·5 per 100,000 COVID-19 cases, exhibiting a decline as the COVID-19 pandemic progressed, from 12·3 cases (Pre-Delta) to 1·3 cases (Omicron); 80% of MIS-C cases occurred during the Omicron variant predominant period, and 72% of children with MIS-C met the KD criteria. Cardiovascular (88%) and gastrointestinal (90%) involvement were frequent. In Japan, MIS-C cases showed comparatively less severe clinical features, with shock in 29% and admission to the intensive care unit in 12% of cases. Coronary artery lesions were identified in 15 cases (11·6%), irrespective of the presence of shock. No fatalities were reported.
Conclusion: The incidence of MIS-C was low in Japan. The clinical features distinctively exhibited a more KD-like phenotype, with less severe clinical features.
Competing Interests: Declarations. Ethics Approval and Consents: This study was approved by the Institutional Review Board of Jichi Medical University (IRB: 23-026) and the respective multicenter institutes involved in this study. The participating sites obtained approval from their local IRB if needed. Written informed consent was not necessary as only deidentified data were used; instead, an opt-out opportunity was made available on the websites of the Department of Public Health at Jichi Medical University and at each participating facility. This study was performed in line with the principles of the Declaration of Helsinki. Competing Interests: The authors declare no competing interests.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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