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

dc.rights.licenseopenen_US
dc.contributor.authorSPEROTTO, Francesca
dc.contributor.authorGUTIERREZ-SACRISTAN, Alba
dc.contributor.authorMAKWANA, Simran
dc.contributor.authorLI, Xiudi
dc.contributor.authorROFEBERG, Valerie N
dc.contributor.authorCAI, Tianxi
dc.contributor.authorBOURGEOIS, Florence T
dc.contributor.authorOMENN, Gilbert S
dc.contributor.authorHANAUER, David A
dc.contributor.authorSAEZ, Carlos
dc.contributor.authorBONZEL, Clara-Lea
dc.contributor.authorBUCHOLZ, Emily
dc.contributor.authorDIONNE, Audrey
dc.contributor.authorELIAS, Matthew D
dc.contributor.authorGARCIA-BARRIO, Noelia
dc.contributor.authorGONZALEZ, Tomas Gonzalez
dc.contributor.authorISSITT, Richard W
dc.contributor.authorKERNAN, Kate F
dc.contributor.authorLAIRD-GION, Jessica
dc.contributor.authorMAIDLOW, Sarah E
dc.contributor.authorMANDL, Kenneth D
dc.contributor.authorAHOOYI, Taha Mohseni
dc.contributor.authorMORALEDA, Cinta
dc.contributor.authorMORRIS, Michele
dc.contributor.authorMOSHAL, Karyn L
dc.contributor.authorPEDRERA-JIMENEZ, Miguel
dc.contributor.authorSHAH, Mohsin A
dc.contributor.authorSOUTH, Andrew M
dc.contributor.authorSPIRIDOU, Anastasia
dc.contributor.authorTAYLOR, Deanne M
dc.contributor.authorVERDY, Guillaume
dc.contributor.authorVISWESWARAN, Shyam
dc.contributor.authorWANG, Xuan
dc.contributor.authorXIA, Zongqi
dc.contributor.authorZACHARIASSE, Joany M
dc.contributor.authorNEWBURGER, Jane W
dc.contributor.authorAVILLACH, Paul
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorGRIFFIER, Romain
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorJOUHET, Vianney
dc.date.accessioned2024-05-15T14:46:59Z
dc.date.available2024-05-15T14:46:59Z
dc.date.issued2023-10-01
dc.identifier.issn2589-5370en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/199897
dc.description.abstractEnBACKGROUND: Multisystem inflammatory syndrome in children (MIS-C) is a severe complication of SARS-CoV-2 infection. It remains unclear how MIS-C phenotypes vary across SARS-CoV-2 variants. We aimed to investigate clinical characteristics and outcomes of MIS-C across SARS-CoV-2 eras. METHODS: We performed a multicentre observational retrospective study including seven paediatric hospitals in four countries (France, Spain, U.K., and U.S.). All consecutive confirmed patients with MIS-C hospitalised between February 1st, 2020, and May 31st, 2022, were included. Electronic Health Records (EHR) data were used to calculate pooled risk differences (RD) and effect sizes (ES) at site level, using Alpha as reference. Meta-analysis was used to pool data across sites. FINDINGS: Of 598 patients with MIS-C (61% male, 39% female; mean age 9.7 years [SD 4.5]), 383 (64%) were admitted in the Alpha era, 111 (19%) in the Delta era, and 104 (17%) in the Omicron era. Compared with patients admitted in the Alpha era, those admitted in the Delta era were younger (ES -1.18 years [95% CI -2.05, -0.32]), had fewer respiratory symptoms (RD -0.15 [95% CI -0.33, -0.04]), less frequent non-cardiogenic shock or systemic inflammatory response syndrome (SIRS) (RD -0.35 [95% CI -0.64, -0.07]), lower lymphocyte count (ES -0.16 x 10(9)/uL [95% CI -0.30, -0.01]), lower C-reactive protein (ES -28.5 mg/L [95% CI -46.3, -10.7]), and lower troponin (ES -0.14 ng/mL [95% CI -0.26, -0.03]). Patients admitted in the Omicron versus Alpha eras were younger (ES -1.6 years [95% CI -2.5, -0.8]), had less frequent SIRS (RD -0.18 [95% CI -0.30, -0.05]), lower lymphocyte count (ES -0.39 x 10(9)/uL [95% CI -0.52, -0.25]), lower troponin (ES -0.16 ng/mL [95% CI -0.30, -0.01]) and less frequently received anticoagulation therapy (RD -0.19 [95% CI -0.37, -0.04]). Length of hospitalization was shorter in the Delta versus Alpha eras (-1.3 days [95% CI -2.3, -0.4]). INTERPRETATION: Our study suggested that MIS-C clinical phenotypes varied across SARS-CoV-2 eras, with patients in Delta and Omicron eras being younger and less sick. EHR data can be effectively leveraged to identify rare complications of pandemic diseases and their variation over time. FUNDING: None.
dc.language.isoENen_US
dc.rightsAttribution 3.0 United States*
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/us/*
dc.subject.enCOVID-19
dc.subject.enClinical phenotypes
dc.subject.enMultisystem inflammatory syndrome
dc.subject.enOutcomes
dc.subject.enPaediatric inflammatory multisystem syndrome
dc.subject.enPediatrics
dc.subject.enSARS-CoV-2
dc.subject.enVariants
dc.title.enClinical phenotypes and outcomes in children with multisystem inflammatory syndrome across SARS-CoV-2 variant eras: a multinational study from the 4CE consortium
dc.title.alternativeEClinicalMedicineen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1016/j.eclinm.2023.102212en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed37745025en_US
bordeaux.journalEClinicalMedicineen_US
bordeaux.page102212en_US
bordeaux.volume64en_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - UMR 1219en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.teamAHEAD_BPHen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.identifierhal-04576780
hal.version1
hal.date.transferred2024-05-15T14:47:04Z
hal.popularnonen_US
hal.audienceInternationaleen_US
hal.exporttrue
dc.rights.ccPas de Licence CCen_US
bordeaux.COinSctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=EClinicalMedicine&rft.date=2023-10-01&rft.volume=64&rft.spage=102212&rft.epage=102212&rft.eissn=2589-5370&rft.issn=2589-5370&rft.au=SPEROTTO,%20Francesca&GUTIERREZ-SACRISTAN,%20Alba&MAKWANA,%20Simran&LI,%20Xiudi&ROFEBERG,%20Valerie%20N&rft.genre=article


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