Lower Risk of Multisystem Inflammatory Syndrome in Children With the Delta and Omicron Variants of Severe Acute Respiratory Syndrome Coronavirus 2

Cohen, Jonathan; Carter, Michael J.; Cheung, C Ronny; Ladhani, Shamez

doi:10.1093/cid/ciac553

Cited by 69 publications

(67 citation statements)

References 5 publications

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“…Rather, SARS-CoV-2 vaccination appears neither to increase nor decrease the risk of PIMS-TS. This is consistent with analyses from the UK [ 16 ] and Denmark [ 17 ], which also found a lower risk of PIMS-TS during the periods when Delta and Omicron were dominant variants.…”

Section: Discussionsupporting

confidence: 90%

SARS-CoV-2 variants and the risk of pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 among children in Germany

et al. 2022

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Purpose To investigate the relationship between the risk of pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) in children and the predominance of different SARS-CoV-2 variants of concern (VOC) over time. Methods In relation to the Alpha, Delta, and Omicron VOC phases of the pandemic, the risk of developing PIMS-TS was calculated by analyzing data for rtPCR-confirmed SARS-CoV-2 infections reported to the German statutory notification system, along with data captured by a separate, national PIMS-TS registry. Both overall infection rates and age group-specific ratios of PIMS-TS during the different pandemic phases were calculated using the Alpha period as the baseline. Results The PIMS-TS rate changed significantly over time. When the Alpha VOC was dominant [calendar week (CW) 11 in March–CW 31 in August 2021], the PIMS-TS rate was 6.19 [95% confidence intervals (95% CI) 5.17, 7.20]. When Delta prevailed (CW 32 in August 2021–CW 4 in January 2022), the rate decreased to 1.68 (95% CI 1.49, 1.87). During the Omicron phase (CW 5 in January–CW 16 in April 2022), the rate fell further to 0.89 (95% CI 0.79, 1.00). These changes correspond to a decreased PIMS-TS rate of 73% (rate ratio 0.271, 95% CI 0.222; 0.332) and 86% (rate ratio 0.048, 95% CI 0.037; 0.062), respectively, in comparison to the Alpha period. Rate ratios were nearly identical for all age groups. Conclusion The data strongly suggest an association between the risk for PIMS-TS and the prevailing VOC, with highest risk related to Alpha and the lowest to Omicron. Given the uniformity of the decreased risk across age groups, vaccination against SARS-CoV-2 does not appear to have a significant impact on the risk of children developing PIMS-TS.

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Section: Discussionsupporting

confidence: 90%

SARS-CoV-2 variants and the risk of pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 among children in Germany

et al. 2022

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show abstract

“…SARS-CoV-2 vaccination does not appear to increase or decrease the risk of PIMS-TS. This is consistent with the analysis from the UK [15] and Denmark [16], which found a lower risk of PIMS-TS during the period with Delta and Omicron as dominant variants.…”

Section: Discussionsupporting

confidence: 92%

“…These, however, were substantial with a reduction of about 70-90%. Previous estimates of the absolute risk of PIMS-TS in Germany [1] and the US [15] yielded an absolute risk of about 1:4,000 for the original Wuhan and the Alpha variant. Thus, the absolute risk for PIMS-TS related to infections with Omicron appears to be between 1:40,000 to 1:80,000.…”

Section: Limitationsmentioning

confidence: 99%

SARS-CoV-2 variants and the risk of Pediatric Inflammatory Multisystem Syndrome temporally associated with SARS-CoV-2 in children in Germany

Sorg

Schönfeld

Hufnagel

et al. 2022

Preprint

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Purpose: To investigate the risk of Pediatric Inflammatory Multisystem Syndrome temporally associated with SARS-CoV-2 (PIMS-TS) in children depending on periods with different dominant variants of concern (VOC) of SARS-CoV-2.Methods: The risk of developing PIMS-TS in three phases of the pandemic with different VOC (Alpha, Delta, and Omicron) was calculated using data of rtPCR confirmed SARS-CoV-2 infections extracted from the German statutory notification system and reports of cases with PIMS-TS captured by a national, prospective registry. Overall and age group-specific rate ratios of PIMS-TS rates in the different observation periods, using the Alpha period as the baseline, were calculated.Results: The rate of PIMS-TS changed significantly over time. During April-August 2021, with dominant VOC Alpha_B.1.1.7, the PIMS-TS rate was 6.19 (95% confidence intervals (95% CI) 5.17, 7.20), decreased to 1.68 (95% CI 1.49, 1.87) in August 2021 to January 2022 with Delta_AY and to 0.89 (95% CI 0.79, 1.00) in January-April 2022 with Omicron_BA as dominant VOC. This corresponds to a decrease in PIMS-TS rate of 73% (rate ratio 0.271, 95% CI 0.222; 0.332) and 86% (rate ratio 0.048, 95% CI 0.037; 0.062), respectively, compared to the Alpha period. Rate ratios were almost identical for all age groups.Conclusion: The data strongly suggest a relation of the risk for PIMS-TS to the prevailing VOC with the highest risk related to Alpha_B.1.1.7 and the lowest with Omicron_BA. Uniformity of the decrease across age groups does not suggest a major role for vaccination on the risk of PIMS-TS in infected children.

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“…Interestingly, in England, for example, the incidence of MIS-C has been decreasing since the delta variant emerged, even in the absence of vaccination during the delta wave and low rates of adolescent vaccination during the omicron wave. 14 Additionally, there are also concerns about post-acute COVID syndrome (PACS), also known as long COVID. In adults, vaccination reduces the risk of PACS, 15 but this finding has not been reported in children.…”

Section: Covid-19 Vaccination For Children Aged 5-11 Yearsmentioning

confidence: 99%

COVID-19 vaccination for children aged 5–11 years

Ladhani

2022

The Lancet

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Lower Risk of Multisystem Inflammatory Syndrome in Children With the Delta and Omicron Variants of Severe Acute Respiratory Syndrome Coronavirus 2

Cited by 69 publications

References 5 publications

SARS-CoV-2 variants and the risk of pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 among children in Germany

SARS-CoV-2 variants and the risk of pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 among children in Germany

SARS-CoV-2 variants and the risk of Pediatric Inflammatory Multisystem Syndrome temporally associated with SARS-CoV-2 in children in Germany

COVID-19 vaccination for children aged 5–11 years

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