Multisystem inflammatory syndrome in children during the COVID-19 waves: data from the Juvenile Inflammatory Rheumatism cohort.

Abstract

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.

• Authors: Robin Kechiche, Charlotte Borocco, Fanny Bajolle, Alexandre Belot, Sylvaine Poignant, Noémie Lachaume, Lucas Percheron, Ulrich Meinzer, Clara Mertes, Véronique Despert, Luc Morin, Virginie Lambert, Perrine Dusser, Nassima Matsa, Véronique Hentgen, Isabelle Kone-Paut, Caroline Galeotti
• Journal: Frontiers in pediatrics (Front Pediatr) Vol. 11 Pg. 1126985 ( 2023) ISSN: 2296-2360 [Print] Switzerland
• PMID: 37292378 (Publication Type: Journal Article)
• Copyright: © 2023 Kechiche, Borocco, Bajolle, Belot, Poignant, Lachaume, Percheron, Meinzer, Mertes, Despert, Morin, Lambert, Dusser, Matsa, Hentgen, Kone-Paut and Galeotti.