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. 2022 Nov 1;41(11):891-898.
doi: 10.1097/INF.0000000000003689. Epub 2022 Sep 7.

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

Laura D Zambrano  1 , Kathleen N Ly  1 , Ruth Link-Gelles  1   2 , Margaret M Newhams  3 , Manzilat Akande  4 , Michael J Wu  1 , Leora R Feldstein  1   2 , Keiko M Tarquinio  5 , Leila C Sahni  6 , Becky J Riggs  7 , Aalok R Singh  8 , Julie C Fitzgerald  9 , Jennifer E Schuster  10 , John S Giuliano Jr  11 , Janet A Englund  12 , Janet R Hume  13 , Mark W Hall  14 , Christina M Osborne  15 , Sule Doymaz  16 , Courtney M Rowan  17 , Christopher J Babbitt  18 , Katharine N Clouser  19 , Steven M Horwitz  20 , Janet Chou  21   22 , Manish M Patel  1   2 , Charlotte Hobbs  23   24 , Adrienne G Randolph  3   22   25 , Angela P Campbell  1 ; Overcoming COVID-19 Investigators
Affiliations

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

Laura D Zambrano et al. Pediatr Infect Dis J. .

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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Conflict of interest statement

The authors have no conflicts of interest to disclose. Individual ICMJE disclosure forms from authors will be provided.

Figures

FIGURE 1.
FIGURE 1.
A: Distribution of social vulnerability index scores, by race and ethnicity. B: Proportion of patients with Medicaid, private insurance, or no insurance/self-pay, by race and ethnicity, among all enrolled patients.
See this image and copyright information in PMC

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