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Risk Factors for Multisystem Inflammatory Syndrome in Children: A Case-Control Investigation
Journal article   Open access   Peer reviewed

Risk Factors for Multisystem Inflammatory Syndrome in Children: A Case-Control Investigation

Laura D. Zambrano, Michael J. Wu, Lora Martin, Lacy Malloch, Sabrina Chen, Margaret M. Newhams, Suden Kucukak, Mary Beth Son, Cameron Sanders, Kayla Patterson, …
The Pediatric infectious disease journal, Vol.42(6), pp.e190-e196
06/2023
DOI: 10.1097/INF.0000000000003900
PMCID: PMC10265536
PMID: 37000922
url
https://doi.org/10.1097/INF.0000000000003900View
Published (Version of record) Open Access

Abstract

Background: In a 2020 pilot case-control study using medical records, we reported that non-Hispanic Black children were more likely to develop multisystem inflammatory syndrome in children (MIS-C) after adjustment for sociodemographic factors and underlying medical conditions. Using structured interviews, we investigated patient, household, and community factors underlying MIS-C likelihood. Methods: MIS-C case patients hospitalized in 2021 across 14 US pediatric hospitals were matched by age and site to outpatient controls testing positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within 3 months of the admission date. Caregiver interviews queried race/ethnicity, medical history, and household and potential community exposures 1 month before MIS-C hospitalization (case-patients) or after SARS-CoV-2 infection (controls). We calculated adjusted odds ratios (aOR) using mixed-effects multivariable logistic regression. Results: Among 275 case patients and 496 controls, race/ethnicity, social vulnerability and patient or family history of autoimmune/rheumatologic disease were not associated with MIS-C. In previously healthy children, MIS-C was associated with a history of hospitalization for an infection [aOR: 4.8; 95% confidence interval (CI): 2.1–11.0]. Household crowding (aOR: 1.7; 95% CI: 1.2–2.6), large event attendance (aOR: 1.7; 95% CI: 1.3–2.1), school attendance with limited masking (aOR: 2.6; 95% CI: 1.1–6.6), public transit use (aOR: 1.8; 95% CI: 1.4–2.4) and co-resident testing positive for SARS-CoV-2 (aOR: 2.2; 95% CI: 1.3–3.7) were associated with increased MIS-C likelihood, with risk increasing with the number of these factors. Conclusions: From caregiver interviews, we clarify household and community exposures associated with MIS-C; however, we did not confirm prior associations between sociodemographic factors and MIS-C
children coronavirus disease 2019 (COVID-19) multisystem inflammatory syndrome in children SARS-CoV-2 risk factors

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