Multisystem inflammatory syndrome in children during the COVID-19 waves : data from the Juvenile Inflammatory Rheumatism cohort
© 2023 Kechiche, Borocco, Bajolle, Belot, Poignant, Lachaume, Percheron, Meinzer, Mertes, Despert, Morin, Lambert, Dusser, Matsa, Hentgen, Kone-Paut and Galeotti..
Introduction: Multisystem inflammatory syndrome in children (MIS-C) is a new condition that first appeared in children and adolescents during the COVID-19 pandemic. We aimed to describe the diagnostic course, clinical and biological manifestations, and treatment of MIS-C during the first three COVID-19 waves.
Methods: We extracted patient data from the Juvenile Inflammatory Rheumatism (JIR) cohort. We analyzed data for patients meeting the World Health Organization diagnostic criteria for MIS-C from the start of the COVID-19 pandemic from March 2020 to June 30, 2021. We then compared data for patients in wave one to those in waves two and three.
Results: We identified 136 patients with MIS-C. The median age decreased but not significantly during the waves, from 9.9 years to 7.3 years (p = 0.105). Boys represented 52.2% (n = 71) of patients, and 46% (n = 41) of patients originated from sub-Saharan Africa (p < 0.001). Patients presented less diarrhea (p = 0.004), respiratory distress (p < 0.001), and myocarditis (p < 0.001) with progressive waves. Biological inflammation also decreased, namely, C-reactive protein level (p < 0.001), neutrophil count (p = 0.004), and albumin level (p < 0.001). Patients received more corticosteroids (p < 0.001) and required less ventilation support (p < 0.01) and less inotrope treatment (p < 0.001) in the later waves. The duration of hospitalization gradually decreased (p < 0.001), as did critical care unit admissions (p = 0.002).
Conclusion: Over the three COVID-19 waves, with a change in the management of MIS-C, children in the JIR cohort in France showed a less severe disease course, in particular, a greater use of corticosteroids. This observation may reflect the impact of both improved management and different SARS-CoV-2 variant.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:11 |
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| Enthalten in: |
Frontiers in pediatrics - 11(2023) vom: 02., Seite 1126985 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Kechiche, Robin [VerfasserIn] |
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| Links: |
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| Themen: |
COVID-19 |
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| Anmerkungen: |
Date Revised 12.06.2023 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.3389/fped.2023.1126985 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 520 | |a © 2023 Kechiche, Borocco, Bajolle, Belot, Poignant, Lachaume, Percheron, Meinzer, Mertes, Despert, Morin, Lambert, Dusser, Matsa, Hentgen, Kone-Paut and Galeotti. | ||
| 520 | |a Introduction: Multisystem inflammatory syndrome in children (MIS-C) is a new condition that first appeared in children and adolescents during the COVID-19 pandemic. We aimed to describe the diagnostic course, clinical and biological manifestations, and treatment of MIS-C during the first three COVID-19 waves | ||
| 520 | |a Methods: We extracted patient data from the Juvenile Inflammatory Rheumatism (JIR) cohort. We analyzed data for patients meeting the World Health Organization diagnostic criteria for MIS-C from the start of the COVID-19 pandemic from March 2020 to June 30, 2021. We then compared data for patients in wave one to those in waves two and three | ||
| 520 | |a Results: We identified 136 patients with MIS-C. The median age decreased but not significantly during the waves, from 9.9 years to 7.3 years (p = 0.105). Boys represented 52.2% (n = 71) of patients, and 46% (n = 41) of patients originated from sub-Saharan Africa (p < 0.001). Patients presented less diarrhea (p = 0.004), respiratory distress (p < 0.001), and myocarditis (p < 0.001) with progressive waves. Biological inflammation also decreased, namely, C-reactive protein level (p < 0.001), neutrophil count (p = 0.004), and albumin level (p < 0.001). Patients received more corticosteroids (p < 0.001) and required less ventilation support (p < 0.01) and less inotrope treatment (p < 0.001) in the later waves. The duration of hospitalization gradually decreased (p < 0.001), as did critical care unit admissions (p = 0.002) | ||
| 520 | |a Conclusion: Over the three COVID-19 waves, with a change in the management of MIS-C, children in the JIR cohort in France showed a less severe disease course, in particular, a greater use of corticosteroids. This observation may reflect the impact of both improved management and different SARS-CoV-2 variant | ||
| 650 | 4 | |a Journal Article | |
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| 650 | 4 | |a epidemiology | |
| 650 | 4 | |a multisystem inflammatory syndrome in children | |
| 650 | 4 | |a myocarditis | |
| 650 | 4 | |a waves of COVID-19 | |
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| 700 | 1 | |a Belot, Alexandre |e verfasserin |4 aut | |
| 700 | 1 | |a Poignant, Sylvaine |e verfasserin |4 aut | |
| 700 | 1 | |a Lachaume, Noémie |e verfasserin |4 aut | |
| 700 | 1 | |a Percheron, Lucas |e verfasserin |4 aut | |
| 700 | 1 | |a Meinzer, Ulrich |e verfasserin |4 aut | |
| 700 | 1 | |a Mertes, Clara |e verfasserin |4 aut | |
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| 700 | 1 | |a Lambert, Virginie |e verfasserin |4 aut | |
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| 700 | 1 | |a Matsa, Nassima |e verfasserin |4 aut | |
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| 700 | 1 | |a Kone-Paut, Isabelle |e verfasserin |4 aut | |
| 700 | 1 | |a Galeotti, Caroline |e verfasserin |4 aut | |
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