INCIDENCE AND RISK FACTORS OF MULTISYSTEM INFLAMMATORY SYNDROME IN CHILDREN (MIS-C) AMONG PEDIATRIC PATIENTS RECEIVING CARE IN A TERTIARY HOSPITAL IN CENTRAL THAILAND

Authors

  • Nutthaporn Narknok Department of Pediatric Cardiology, Ananda Mahidol Hospital
  • Boonsub Sakboonyarat Department of Military and Community Medicine, Phramongkutklao College of Medicine

DOI:

https://doi.org/10.55374/jseamed.v7.182

Keywords:

MIS-C, SARS-CoV-2, C-Reactive Protein, Thailand

Abstract

Background: Multisystem Inflammatory Syndrome in Children (MIS-C) involves severe complications after contracting SARS-CoV-2. Nevertheless, limited evidence is available of MIS-C incidence in Thailand. Therefore, the present study aimed to determine MIS-C incidence and its risk factors among Thai children.

Methods: A retrospective cohort study was conducted between 2020 and 2021. The data were obtained from medical records of pediatric patients under 15 years receiving a diagnosis of SARS-CoV-2 and obtaining treatment at Ananda Mahidol Hospital, Lopburi Province, central Thailand. The World Health Organization defined MIS-C incidence as occurring within eight weeks after contracting SARS-CoV-2. A multivariable Cox proportional hazard regression model was used for estimating the adjusted hazard ratio (AHR) and 95% confidence interval (CI) for factors associated with MIS-C.

Results: Three thousand pediatric patients with a history of SARS-CoV-2 were included in the present study. The majority (51%) were males. The median time of follow-up was 56 days. Twenty-five patients (0.83%) developed MIS-C, representing an incidence rate of 14.95 (95% CI: 9.67–22.07) per 100,000 person-days. The incidence rates among males and females were 18.77 (95% CI: 10.73–30.49) and 10.97 (95% CI: 5.02–20.83) per 100,000 person-days, respectively (p-value = 0.192). After adjusting for potential confounders, independent risk factors for MIS-C included a history of asthma (AHR: 7.65; 95% CI: 1.69–34.67), history of allergic rhinitis (AHR: 15.71; 95% CI: 5.73–43.05), history of nephrotic syndrome (AHR: 49.6; 95% CI: 5.89–417.06), every 10 mg/dL increase of C-reactive protein (AHR: 1.71; 95% CI: 1.28–2.29) and having COVID-19-related symptoms involving at least two systems (AHR: 9.36; 95% CI: 2.2–39.78) compared with those involving less than two systems.

Conclusion: A modest incidence of MIS-C was estimated among Thai children, while a higher incidence of MIS-C among male patients was observed. Factors associated with MIS-C included underlying diseases and elevated C-reactive protein levels in SARS-CoV-2.

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Author Biography

Nutthaporn Narknok, Department of Pediatric Cardiology, Ananda Mahidol Hospital

Department of Pediatric Cardiology, Ananda Mahidol Hospital

Department of Pediatrics, Phramongkutklao College of Medicine

References

Velavan TP, Meyer CG. The COVID-19 epidemic. Trop Med Int Health 2020; 25: 278-80. DOI: https://doi.org/10.1111/tmi.13383

Organization WH. Multisystem inflammatory syndrome in children and adolescents with COVID-19: scientific brief, May 15 2020. World Health Organization; 2020. Available from:https://www.who.int/news-room/commentaries/detail/multisysteminflammatorysyndrome-in-children-and-adolescents-withcovid-19.

Prevention C for DC and Multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 (COVID-19). CDC Health Alert Network. 2020. Available from: https://www.cdc.gov/mis/mis-c.html.

RCoPaC H. Guidance: paediatric multisystem inflammatory syndrome temporally associated with COVID-19. Royal College of Paediatrics and Child Health London 2020. Available from: https://www.rcpch.ac.uk/resources/paediatric-multisystem-inflammatorysyndrome-temporally-associated-covid-19-pims-guidance.

Feldstein LR, Tenforde MW, Friedman KG, Newhams M, Rose EB, Dapul H, et al. Overcoming COVID-19 Investigators. Characteristics and outcomes of US children and adolescents with multisystem inflammatory syndrome in children (MIS-C) Compared With Severe Acute COVID-19. JAMA 2021; 325: 1074-87. DOI: https://doi.org/10.1001/jama.2021.2091

Evans C, Davies P. SARS-CoV-2 paediatric inflammatory syndrome. Paediatr Child Health (Oxford) 2021; 31: 110-5. DOI: https://doi.org/10.1016/j.paed.2020.12.003

Payne AB, Gilani Z, Godfred-Cato S, Belay ED, Feldstein LR, Patel MM, et al. Incidence of multisystem inflammatory syndrome in children among US persons infected with SARS-CoV-2. JAMA Netw Open 2021; 4: e2116420.

Yorsaeng R, Suntronwong N, Thongpan I, Chuchaona W, Lestari FB, Pasittungkul S, et al. The impact of COVID-19 and control measures on public health in Thailand, 2020. Peer J 2022; 10: e12960. DOI: https://doi.org/10.7717/peerj.12960

Abrams JY, Godfred-Cato SE, Oster ME, Chow EJ, Koumans EH, Bryant B, et al.Multisystem inflammatory syndrome in children associated with severe acute respiratory syndrome coronavirus 2: A systematic review. J Pediatr 2020; 226: 45-54. DOI: https://doi.org/10.1016/j.jpeds.2020.08.003

La Torre F, Elicio MP, Monno VA, Chironna M, Moramarco F, Campanozzi A, et al. Incidence and prevalence of multisystem inflammatory syndrome in children (MIS-C) in southern Italy. Children (Basel) 2023; 10: 766. DOI: https://doi.org/10.3390/children10050766

Rhedin S, Lundholm C, Horne A, Smew AI, Osvald EC, Haddadi A, et al. Swedish Pediatric MIS-C Consortium; Brew BH, Almqvist C. Risk factors for multisystem inflammatory syndrome in children - A population-based cohort study of over 2 million children. Lancet Reg Health Eur 2022; 19: 100443. DOI: https://doi.org/10.1016/j.lanepe.2022.100443

Scully EP, Haverfield J, Ursin RL, Tannenbaum C, Klein SL. Considering how biological sex impacts immune responses and COVID-19 outcomes. Nat Rev Immunol 2020; 20: 442-7. DOI: https://doi.org/10.1038/s41577-020-0348-8

Papi A, Johnston SL. Rhinovirus infection induces expression of its own receptor intercellular adhesion molecule 1 (ICAM-1) via increased NF-kappaB-mediated transcription. J Biol Chem 1999; 274: 9707-20. DOI: https://doi.org/10.1074/jbc.274.14.9707

Yeh SY, Schwartzstein R. Asthma: Pathophysiology and diagnosis. Asthma, Health and Society: A Public Health Perspective 2010; 19–42. DOI: https://doi.org/10.1007/978-0-387-78285-0_2

Shi T, Pan J, Katikireddi SV, McCowan C, Kerr S, Agrawal U, et al. Public Health Scotland and the EAVE II collaborators. Risk of COVID-19 hospital admission among children aged 5-17 years with asthma in Scotland: a national incident cohort study. Lancet Respir Med 2022; 10: 191-8. DOI: https://doi.org/10.1016/S2213-2600(21)00491-4

Cirks BT, Rowe SJ, Jiang SY, Brooks RM, Mulreany MP, Hoffner W, et al. Sixteen weeks later: expanding the risk period for multisystem inflammatory syndrome in children. J Pediatric Infect Dis Soc 2021; 10:686- 90. DOI: https://doi.org/10.1093/jpids/piab007

Min YG. The pathophysiology, diagnosis and treatment of allergic rhinitis. Allergy Asthma Immunol Res 2010; 2: 65-76. DOI: https://doi.org/10.4168/aair.2010.2.2.65

Menon S. Acute Kidney Injury in Nephrotic Syndrome. Front Pediatr 2019; 6: 428. DOI: https://doi.org/10.3389/fped.2018.00428

Godfred-Cato S, Bryant B, Leung J, Oster ME, Conklin L, Abrams J, et al. California MIS-C response team. COVID-19-associated multisystem inflammatory syndrome in children - United States, March-July 2020. MMWR Morb Mortal Wkly Rep 2020; 69: 1074-80. DOI: https://doi.org/10.15585/mmwr.mm6932e2

Toubiana J, Poirault C, Corsia A, Bajolle F, Fourgeaud J, Angoulvant F, et al. Kawasakilike multisystem inflammatory syndrome in children during the covid-19 pandemic in Paris, France: prospective observational study. BMJ 2020; 369: m2094. DOI: https://doi.org/10.1136/bmj.m2094

Verdoni L, Mazza A, Gervasoni A, Martelli L, Ruggeri M, Ciuffreda M, et al. An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study. Lancet 2020; 395: 1771-8. DOI: https://doi.org/10.1016/S0140-6736(20)31103-X

Riphagen S, Gomez X, Gonzalez-Martinez C, Wilkinson N, Theocharis P. Hyperinflammatory shock in children during COVID-19 pandemic. Lancet. 2020; 395: 1607-8. DOI: https://doi.org/10.1016/S0140-6736(20)31094-1

Feldstein LR, Rose EB, Horwitz SM, Collins JP, Newhams MM, Son MBF et al. Overcoming COVID-19 investigators; CDC COVID-19 response team. multisystem inflammatory syndrome in US children and adolescents. N Engl J Med 2020; 383: 334-46. DOI: https://doi.org/10.1056/NEJMoa2021680

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Published

2023-10-24

How to Cite

1.
Narknok N, Sakboonyarat B. INCIDENCE AND RISK FACTORS OF MULTISYSTEM INFLAMMATORY SYNDROME IN CHILDREN (MIS-C) AMONG PEDIATRIC PATIENTS RECEIVING CARE IN A TERTIARY HOSPITAL IN CENTRAL THAILAND. J Southeast Asian Med Res [Internet]. 2023 Oct. 24 [cited 2024 Oct. 15];7:e0182. Available from: https://jseamed.org/index.php/jseamed/article/view/182

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