Although still rare, MIS-C after Covid-19 has been more common and more severe than previously reported, and there are significant racial disparities in cases, according to a study published Thursday in JAMA Network Open.
Multisystem inflammatory syndrome in children – which appears mainly after Covid-19 infection – causes inflammation in various parts of the body and can affect major organs including the kidneys, brain, lungs and heart. It can be serious, even fatal.
The US Centers for Disease Control and Prevention currently relies on voluntary case reporting by local health departments for MIS-C surveillance. Through November, they recorded a total of around 9,000 cases and 74 deaths from MIS-C out of the millions of Covid-19 cases in children.
A formal diagnostic code was established for MIS-C in 2021, and the new research analyzed records collected by the Agency for Healthcare Research and Quality from thousands of hospitals representing more than three-quarters of the American population.
He revealed that for every 100 children hospitalized with Covid-19 in 2021, there were approximately 17 MIS-C hospitalizations. MIS-C hospitalizations were generally younger and more likely to occur in male children than Covid-19 hospitalizations.
The more organs affected, the worse the results. As the number of affected organ systems increased from two to six or more, mortality rose from 1% to 6%, according to the new research. Length of hospital stay doubled from four to eight days, and adverse drug events more than tripled from 5% to 18%.
Overall, more than 60% of children hospitalized with MIS-C had more than two organ systems affected. Among them, about 8% of patients had at least six organ systems affected.
Racial disparities in Covid-19 outcomes are well established, and this new research found even starker differences in MIS-C outcomes.
MIS-C hospitalizations were twice as likely in black children as in white children. And while black children accounted for about 24% of all MIS-C cases, they accounted for 32% of the most severe cases affecting at least six organ systems.
The researchers also found that “the severity of MIS-C for black children was likely exacerbated by socioeconomic factors,” with those living in the most socially vulnerable communities typically spending an extra day in hospital. They did not find the same link when it came to hospitalizations related to Covid-19.
These results “increase our knowledge of disparities and outcomes of MIS-C and COVID-19, shedding light on the risks and impacts of increasing organ system dysfunction,” according to a comment on the study from pediatricians and physicians. researchers from the University of Colorado School of Medicine.
But they raise even more critical questions, including the specific reasons for the vast racial disparities.
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