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. 2023 Nov 1;152(5):e2023062101.
doi: 10.1542/peds.2023-062101.

Epidemiology and Severity of Illness of MIS-C and Kawasaki Disease During the COVID-19 Pandemic

Matthew J Molloy  1   2 , Katherine A Auger  1   2   3 , Matt Hall  4 , Samir S Shah  1   2 , Amanda C Schondelmeyer  1   2   3 , Kavita Parikh  5 , Katherine M Kazmier  6 , Harita Katragadda  7   8 , Seethal A Jacob  9 , Karen E Jerardi  1   2 , Rebecca Ivancie  10 , David Hartley  2   3 , Mersine A Bryan  6   11 , Samina Bhumbra  12 , Staci D Arnold  13 , Patrick W Brady  1   2   3
Affiliations

Epidemiology and Severity of Illness of MIS-C and Kawasaki Disease During the COVID-19 Pandemic

Matthew J Molloy et al. Pediatrics. .

Abstract

Background and objectives: Multisystem inflammatory syndrome in children (MIS-C) is a novel, severe condition following severe acute respiratory syndrome coronavirus 2 infection. Large epidemiologic studies comparing MIS-C to Kawasaki disease (KD) and evaluating the evolving epidemiology of MIS-C over time are lacking. We sought to understand the illness severity of MIS-C compared with KD and evaluate changes in MIS-C illness severity over time during the coronavirus disease 2019 pandemic compared with KD.

Methods: We included hospitalizations of children with MIS-C and KD from April 2020 to May 2022 from the Pediatric Health Information System administrative database. Our primary outcome measure was the presence of shock, defined as the use of vasoactive/inotropic cardiac support or extracorporeal membrane oxygenation. We examined the volume of MIS-C and KD hospitalizations and the proportion of hospitalizations with shock over time using 2-week intervals. We compared the proportion of hospitalizations with shock in MIS-C and KD patients over time using generalized estimating equations adjusting for hospital clustering and age, with time as a fixed effect.

Results: We identified 4868 hospitalizations for MIS-C and 2387 hospitalizations for KD. There was a higher proportion of hospitalizations with shock in MIS-C compared with KD (38.7% vs 5.1%). In our models with time as a fixed effect, we observed a significant decrease in the odds of shock over time in MIS-C patients (odds ratio 0.98, P < .001) but not in KD patients (odds ratio 1.00, P = .062).

Conclusions: We provide further evidence that MIS-C is a distinct condition from KD. MIS-C was a source of lower morbidity as the pandemic progressed.

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Conflict of interest statement

CONFLICT OF INTEREST DISCLOSURES: The authors have indicated they have no potential conflicts of interest relevant to this article to disclose.

Figures

FIGURE 1
FIGURE 1
Volume of hospitalization and proportion of hospitalizations with shock for MIS-C and KD. (A) Volume of hospitalization for MIS-C and KD. (B) Proportion of hospitalizations with shock for MIS-C and KD. Data shown every 2 weeks from January 2019 to May 2022 with COVID-19 waves indicated with shading.
See this image and copyright information in PMC

References

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Publication types

Supplementary concepts