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

Details

• Alternative Title:
  Pediatr Infect Dis J
• Personal Author:
  Zambrano, Laura D. ; Wu, Michael J. ; Martin, Lora ; Malloch, Lacy ; Chen, Sabrina ; Newhams, Margaret M. ; Kucukak, Suden ; Son, Mary Beth ; Sanders, Cameron ; Patterson, Kayla ; Halasa, Natasha ; Fitzgerald, Julie C. ; Leroue, Matthew K. ; Hall, Mark ; Irby, Katherine ; Rowan, Courtney M. ; Wellnitz, Kari ; Sahni, Leila C. ; Loftis, Laura ; Bradford, Tamara T. ; Staat, Mary ; Babbitt, Christopher ; Carroll, Christopher L. ; Pannaraj, Pia S. ; Kong, Michele ; Schuster, Jennifer E. ; Chou, Janet ; Patel, Manish M. ; Randolph, Adrienne G. ; Campbell, Angela P. ; Hobbs, Charlotte V.
• Corporate Authors:
  Overcoming COVID-19 investigators
• Description:
  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.
  
  
• Subjects:
  Case-Control Studies Child COVID-19 Crowding Family Characteristics Humans Risk Factors SARS-CoV-2 Systemic Inflammatory Response Syndrome
• Keywords:
  Children Coronavirus Disease 2019 (COVID-19) Multisystem Inflammatory Syndrome In Children Risk Factors
• Source:
  Pediatr Infect Dis J. 42(6):e190-e196
• Pubmed ID:
  37000922
• Pubmed Central ID:
  PMC10265536
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/ ; K23 DK119463/DK/NIDDK NIH HHSUnited States/
• Volume:
  42
• Issue:
  6
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:e1b7de5ac650e67941abc78953790bea0d23369ed07bdaa12b30c72f9a94e0804befa314f448fc9968e4f4dbc755932d51adeae827aabfca5d449b914275dd07
• Download URL:
  https://stacks.cdc.gov/view/cdc/129870/cdc_129870_DS1.pdf
• File Type:
  [PDF - 576.62 KB ]