MIS-C across three SARS-CoV-2 variants: Changes in COVID-19 testing and clinical characteristics in a cohort of U.S. children

Laird‐Gion, Jessica; Dionne, Audrey; Baker, Annette L.; Day‐Lewis, Megan; Ferranti, Sarah D. de; Friedman, Kevin G.; Khan, Numaira; Mahanta, Simran; Son, Mary Beth; Sperotto, Francesca

doi:10.1007/s00431-023-04968-4

Cited by 10 publications

(8 citation statements)

References 16 publications

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“…Given the severity of presentation in MIS-C it is not surprising that the majority ( n = 46, 63%) of our MIS-C population were admitted to the intensive care unit ( 9 ). Throughout the pandemic this remained true as the clinical severity of MIS-C was similar across Alpha, Delta and Omricon SARS-CoV-2 strains ( 33 ).…”

Section: Discussionmentioning

confidence: 93%

The prevalence and outcomes of hyponatremia in children with COVID-19 and multisystem inflammatory syndrome in children (MIS-C)

Dalal,

Pfaff,

Silver

et al. 2023

Front. Pediatr.

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IntroductionTo assess the prevalence of hyponatremia among pediatric patients with coronavirus disease 2019 (COVID-19) and Multisystem Inflammatory Syndrome in Children (MIS-C) and determine if pediatric hyponatremia was associated with an increased length of stay, higher rates of mechanical ventilation, and/or elevated inflammatory markers on admission as compared to eunatremic patients.MethodsElectronic health records were retrospectively analyzed for 168 children less than 18 years old with COVID-19 or MIS-C who were admitted to pediatric units within the Northwell Health system. The primary exposure was hyponatremic status (serum sodium <135 mEq/L) and the primary outcomes were length of stay, mechanical ventilation usage and increased inflammatory markers.ResultsOf the 168 children in the study cohort, 95 (56%) were admitted for COVID-19 and 73 (43.5%) for MIS-C. Overall, 60 (35.7%) patients presented with hyponatremia on admission. Patients with hyponatremia had higher rates of intensive care unit admission when compared to eunatremic patients (32/60 [53.3%] vs. 39/108 [36.1%], p = 0.030). In regression models, hyponatremia was not significantly associated with increased length of stay or mechanical ventilation rates. After adjustment for relevant confounders, hyponatremia remained associated with an increased square root CRP (β = 1.79: 95% CI: 0.22–3.36) and lower albumin levels (β = −0.22: 95% CI: −0.42–−0.01).ConclusionHyponatremia is common in pediatric COVID-19 and MIS-C. Hyponatremia was associated with a lower albumin and higher square root CRP levels. This may suggest an association of inflammation with lower serum sodium levels.

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Section: Discussionmentioning

confidence: 93%

The prevalence and outcomes of hyponatremia in children with COVID-19 and multisystem inflammatory syndrome in children (MIS-C)

Dalal,

Pfaff,

Silver

et al. 2023

Front. Pediatr.

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“… 7 , 21 , 22 In this context, recent studies have focused on investigating if MIS-C phenotypes may vary as well, based on SARS-CoV-2 variants. 6 , 7 , 8 , 10 , 11 , 12 , 13 Compared with EHR studies that selected patients with COVID-19-related conditions using diagnostic codes as the inclusion criteria, our study design had the advantage of patient selection using lists of patients with MIS-C validated by MIS-C experts at the site level.…”

Section: Discussionmentioning

confidence: 99%

“… 8 However, other smaller single-centre and multicentre reports from South Africa, Europe, and the U.S. found no difference in MIS-C outcomes across SAS-CoV-2 variant eras. 9 , 10 , 11 , 12 , 13 …”

Section: Introductionmentioning

confidence: 99%

Clinical phenotypes and outcomes in children with multisystem inflammatory syndrome across SARS-CoV-2 variant eras: a multinational study from the 4CE consortium

Sperotto,

Gutiérrez-Sacristán,

Makwana

et al. 2023

eClinicalMedicine

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“…10–12 For the most recent Omicron lineage, breakthrough infections are encountered more frequently than with any other VOCs due to substantial evolution and consequent immune evasion to available vaccines. 13 , 14 For instance, three-dose vaccination is effective against Delta infection but less effective against Omicron infection. 15 Although two doses of the BNT162b2 vaccine are associated with high protection against SARS-CoV-2 infection within 6 months, 16 primary immunization alone is not enough to protect individuals from breakthrough infection by multiple VOCs.…”

Section: Introductionmentioning

confidence: 99%

Enhanced immunity against SARS-CoV-2 in returning Chinese individuals

Yuan,

Chen,

et al. 2024

Human Vaccines & Immunotherapeutics

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Global COVID-19 vaccination programs effectively contained the fast spread of SARS-CoV-2. Characterizing the immunity status of returned populations will favor understanding the achievement of herd immunity and long-term management of COVID-19 in China. Individuals were recruited from 7 quarantine stations in Guangzhou, China. Blood and throat swab specimens were collected from participants, and their immunity status was determined through competitive ELISA, microneutralization assay and enzyme-linked FluoroSpot assay. A total of 272 subjects were involved in the questionnaire survey, of whom 235 (86.4%) were returning Chinese individuals and 37 (13.6%) were foreigners. Blood and throat swab specimens were collected from 108 returning Chinese individuals. Neutralizing antibodies against SARS-CoV-2 were detected in ~90% of returning Chinese individuals, either in the primary or the homologous and heterologous booster vaccination group. The serum NAb titers were significantly decreased against SARS-CoV-2 Omicron BA.5, BF.7, BQ.1 and XBB.1 compared with the prototype virus. However, memory T-cell responses, including specific IFN-γ and IL-2 responses, were not different in either group. Smoking, alcohol consumption, SARS-CoV-2 infection, COVID-19 vaccination, and the time interval between last vaccination and sampling were independent influencing factors for NAb titers against prototype SARS-CoV-2 and variants of concern. The vaccine dose was the unique common influencing factor for Omicron subvariants. Enhanced immunity against SARS-CoV-2 was established in returning Chinese individuals who were exposed to reinfection and vaccination. Domestic residents will benefit from booster homologous or heterologous COVID-19 vaccination after reopening of China, which is also useful against breakthrough infection.

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MIS-C across three SARS-CoV-2 variants: Changes in COVID-19 testing and clinical characteristics in a cohort of U.S. children

Cited by 10 publications

References 16 publications

The prevalence and outcomes of hyponatremia in children with COVID-19 and multisystem inflammatory syndrome in children (MIS-C)

The prevalence and outcomes of hyponatremia in children with COVID-19 and multisystem inflammatory syndrome in children (MIS-C)

Clinical phenotypes and outcomes in children with multisystem inflammatory syndrome across SARS-CoV-2 variant eras: a multinational study from the 4CE consortium

Enhanced immunity against SARS-CoV-2 in returning Chinese individuals

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