NYMC Faculty Publications

Investigating Health Disparities Associated With Multisystem Inflammatory Syndrome in Children After SARS-Cov-2 Infection

Laura D. Zambrano, From the COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia.
Kathleen N. Ly, From the COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia.
Ruth Link-Gelles, From the COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia.
Margaret M. Newhams, Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts.
Manzilat Akande, Department of Pediatrics-Section of Critical Care, The University of Oklahoma College of Medicine, Oklahoma City, Oklahoma.
Michael J. Wu, From the COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia.
Leora R. Feldstein, From the COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia.
Keiko M. Tarquinio, Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia.
Leila C. Sahni, Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Immunization Project, Houston, Texas.
Becky J. Riggs, Department of Anesthesiology and Critical Care Medicine; Division of Pediatric Anesthesiology & Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland.
Aalok R. Singh, Pediatric Critical Care Division, Maria Fareri Children's Hospital at Westchester Medical Center and New York Medical College, Valhalla, New York.
Julie C. Fitzgerald, Division of Critical Care, Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
Jennifer E. Schuster, Division of Pediatric Infectious Disease, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri.
John S. Giuliano, Department of Pediatrics, Division of Critical Care, Yale University School of Medicine, New Haven, Connecticut.
Janet A. Englund, Department of Pediatrics, School of Medicine, Seattle Children's Research Institute, University of Washington, Seattle, Washington.
Janet R. Hume, Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota.
Mark W. Hall, Division of Critical Care Medicine, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio.
Christina M. Osborne, Department of Pediatrics, Sections of Critical Care Medicine and Infectious Diseases, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado.
Sule Doymaz, Division of Pediatric Critical Care, Department of Pediatrics, SUNY Downstate Health Sciences University, Brooklyn, New York.
Courtney M. Rowan, Division of Pediatric Critical Care Medicine, Department of Pediatrics, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, Indiana.
Christopher J. Babbitt, Division of Pediatric Critical Care Medicine, Miller Children's and Women's Hospital of Long Beach, Long Beach, California.
Katharine N. Clouser, Department of Pediatrics, Hackensack Meridian School of Medicine, Hackensack, New Jersey.
Steven M. Horwitz, Department of Pediatrics, Division of Critical Care, Bristol-Myers Squibb Children's Hospital, New Brunswick, New Jersey.
Janet Chou, Division of Immunology, Boston Children's Hospital, Boston, Massachusetts.
Manish M. Patel, From the COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia.
Charlotte Hobbs, Pediatrics.
Adrienne G. Randolph, Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts.
Angela P. Campbell, From the COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia.

Author Type(s)

Faculty

Journal Title

The Pediatric Infectious Disease Journal

First Page

891

Last Page

898

Document Type

Article

Publication Date

11-1-2022

Department

Pediatrics

Abstract

BACKGROUND: Multisystem inflammatory syndrome in children (MIS-C) is a postinfectious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related complication that has disproportionately affected racial/ethnic minority children. We conducted a pilot study to investigate risk factors for MIS-C aiming to understand MIS-C disparities. METHODS: This case-control study included MIS-C cases and SARS-CoV-2-positive outpatient controls less than 18 years old frequency-matched 4:1 to cases by age group and site. Patients hospitalized with MIS-C were admitted between March 16 and October 2, 2020, across 17 pediatric hospitals. We evaluated race, ethnicity, social vulnerability index (SVI), insurance status, weight-for-age and underlying medical conditions as risk factors using mixed effects multivariable logistic regression. RESULTS: We compared 241 MIS-C cases with 817 outpatient SARS-CoV-2-positive at-risk controls. Cases and controls had similar sex, age and U.S. census region distribution. MIS-C patients were more frequently previously healthy, non-Hispanic Black, residing in higher SVI areas, and in the 95th percentile or higher for weight-for-age. In the multivariable analysis, the likelihood of MIS-C was higher among non-Hispanic Black children [adjusted odds ratio (aOR): 2.07; 95% CI: 1.23-3.48]. Additionally, SVI in the 2nd and 3rd tertiles (aOR: 1.88; 95% CI: 1.18-2.97 and aOR: 2.03; 95% CI: 1.19-3.47, respectively) were independent factors along with being previously healthy (aOR: 1.64; 95% CI: 1.18-2.28). CONCLUSIONS: In this study, non-Hispanic Black children were more likely to develop MIS-C after adjustment for sociodemographic factors, underlying medical conditions, and weight-for-age. Investigation of the potential contribution of immunologic, environmental, and other factors is warranted.

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