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. 2023 Jun;51(3):729-735.
doi: 10.1007/s15010-022-01908-6. Epub 2022 Sep 1.

SARS-CoV-2 variants and the risk of pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 among children in Germany

A L Sorg  1   2 , V Schönfeld  3 , A Siedler  3 , M Hufnagel  4 , M Doenhardt  5 , N Diffloth  5 , R Berner  5 , R V Kries  1 , J Armann  6
Affiliations

SARS-CoV-2 variants and the risk of pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 among children in Germany

A L Sorg et al. Infection. 2023 Jun.

Abstract

Purpose: To investigate the relationship between the risk of pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) in children and the predominance of different SARS-CoV-2 variants of concern (VOC) over time.

Methods: In relation to the Alpha, Delta, and Omicron VOC phases of the pandemic, the risk of developing PIMS-TS was calculated by analyzing data for rtPCR-confirmed SARS-CoV-2 infections reported to the German statutory notification system, along with data captured by a separate, national PIMS-TS registry. Both overall infection rates and age group-specific ratios of PIMS-TS during the different pandemic phases were calculated using the Alpha period as the baseline.

Results: The PIMS-TS rate changed significantly over time. When the Alpha VOC was dominant [calendar week (CW) 11 in March-CW 31 in August 2021], the PIMS-TS rate was 6.19 [95% confidence intervals (95% CI) 5.17, 7.20]. When Delta prevailed (CW 32 in August 2021-CW 4 in January 2022), the rate decreased to 1.68 (95% CI 1.49, 1.87). During the Omicron phase (CW 5 in January-CW 16 in April 2022), the rate fell further to 0.89 (95% CI 0.79, 1.00). These changes correspond to a decreased PIMS-TS rate of 73% (rate ratio 0.271, 95% CI 0.222; 0.332) and 86% (rate ratio 0.048, 95% CI 0.037; 0.062), respectively, in comparison to the Alpha period. Rate ratios were nearly identical for all age groups.

Conclusion: The data strongly suggest an association between the risk for PIMS-TS and the prevailing VOC, with highest risk related to Alpha and the lowest to Omicron. Given the uniformity of the decreased risk across age groups, vaccination against SARS-CoV-2 does not appear to have a significant impact on the risk of children developing PIMS-TS.

Keywords: COVID-19; MIS-C; PIMS-TS; Risk; SARS-CoV-2; Variants.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose and have no competing interests to declare that are relevant to the content of this article.

Figures

Fig. 1
Fig. 1
Rate ratios of the pediatric PIMS-TS rate per age group during different periods of the SARS-CoV-2 pandemic with different dominant VOC in Germany: Alpha—calendar week (CW) 11 in March to CW 31 in August 2021; Delta—CW 32 in August 2021 to CW 4 in January 2022; Omicron—CW 5 in January to CW 16 in April 2022
Fig. 2
Fig. 2
Vaccination coverage for 2 vaccine doses in children < 18 years of age in Germany from 2021 to calendar week (CW) 11 in 2022. Round icons indicate vaccination coverage in 12–17 year-old children and adolescents, while triangular icons indicate vaccination coverage of 5–11 year-olds
See this image and copyright information in PMC

References

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Supplementary concepts