Incidence of Multisystem Inflammatory Syndrome in Children among US Persons Infected with SARS-CoV-2

Amanda B. Payne; Zunera Gilani; Shana Godfred-Cato; Ermias D. Belay; Leora R. Feldstein; Manish M. Patel; Adrienne G. Randolph; Margaret Newhams; Deepam Thomas; Reed Magleby; Katherine Hsu; Meagan Burns; Elizabeth Dufort; Angie Maxted; Michael Pietrowski; Allison Longenberger; Sally Bidol; Justin Henderson; Lynn Sosa; Alexandra Edmundson; Melissa Tobin-D'Angelo; Laura Edison; Sabrina Heidemann; Aalok R. Singh; John S. Giuliano; Lawrence C. Kleinman; Keiko M. Tarquinio; Rowan F. Walsh; Julie C. Fitzgerald; Katharine N. Clouser; Shira J. Gertz; Ryan W. Carroll; Christopher L. Carroll; Brooke E. Hoots; Carrie Reed; F. Scott Dahlgren; Matthew E. Oster; Timmy J. Pierce; Aaron T. Curns; Gayle E. Langley; Angela P. Campbell; Neha Balachandran; Thomas S. Murray; Cole Burkholder; Troy Brancard; Jenna Lifshitz; Dylan Leach; Ian Charpie; Cory Tice; Susan E. Coffin; Dana Perella; Kaitlin Jones; Kimberly L. Marohn; Phoebe H. Yager; Neil D. Fernandes; Heidi R. Flori; Monica L. Koncicki; Karen S. Walker; Maria Cecilia Di Pentima; Simon Li; Steven M. Horwitz; Sunanda Gaur; Dennis C. Coffey; Ilana Harwayne-Gidansky; Saul R. Hymes; Neal J. Thomas; Kate G. Ackerman; Jill M. Cholette

doi:10.1001/jamanetworkopen.2021.16420

Incidence of Multisystem Inflammatory Syndrome in Children among US Persons Infected with SARS-CoV-2

Amanda B. Payne, Zunera Gilani, Shana Godfred-Cato, Ermias D. Belay, Leora R. Feldstein, Manish M. Patel, Adrienne G. Randolph, Margaret Newhams, Deepam Thomas, Reed Magleby, Katherine Hsu, Meagan Burns, Elizabeth Dufort, Angie Maxted, Michael Pietrowski, Allison Longenberger, Sally Bidol, Justin Henderson, Lynn Sosa, Alexandra EdmundsonMelissa Tobin-D'Angelo, Laura Edison, Sabrina Heidemann, Aalok R. Singh, John S. Giuliano, Lawrence C. Kleinman, Keiko M. Tarquinio, Rowan F. Walsh, Julie C. Fitzgerald, Katharine N. Clouser, Shira J. Gertz, Ryan W. Carroll, Christopher L. Carroll, Brooke E. Hoots, Carrie Reed, F. Scott Dahlgren, Matthew E. Oster, Timmy J. Pierce, Aaron T. Curns, Gayle E. Langley, Angela P. Campbell, Neha Balachandran, Thomas S. Murray, Cole Burkholder, Troy Brancard, Jenna Lifshitz, Dylan Leach, Ian Charpie, Cory Tice, Susan E. Coffin, Dana Perella, Kaitlin Jones, Kimberly L. Marohn, Phoebe H. Yager, Neil D. Fernandes, Heidi R. Flori, Monica L. Koncicki, Karen S. Walker, Maria Cecilia Di Pentima, Simon Li, Steven M. Horwitz, Sunanda Gaur, Dennis C. Coffey, Ilana Harwayne-Gidansky, Saul R. Hymes, Neal J. Thomas, Kate G. Ackerman, Jill M. Cholette

Research output: Contribution to journal › Article › peer-review

273 Scopus citations

Abstract

Importance: Multisystem inflammatory syndrome in children (MIS-C) is associated with recent or current SARS-CoV-2 infection. Information on MIS-C incidence is limited. Objective: To estimate population-based MIS-C incidence per 1000000 person-months and to estimate MIS-C incidence per 1000000 SARS-CoV-2 infections in persons younger than 21 years. Design, Setting, and Participants: This cohort study used enhanced surveillance data to identify persons with MIS-C during April to June 2020, in 7 jurisdictions reporting to both the Centers for Disease Control and Prevention national surveillance and to Overcoming COVID-19, a multicenter MIS-C study. Denominators for population-based estimates were derived from census estimates; denominators for incidence per 1000000 SARS-CoV-2 infections were estimated by applying published age- and month-specific multipliers accounting for underdetection of reported COVID-19 case counts. Jurisdictions included Connecticut, Georgia, Massachusetts, Michigan, New Jersey, New York (excluding New York City), and Pennsylvania. Data analyses were conducted from August to December 2020. Exposures: Race/ethnicity, sex, and age group (ie, ≤5, 6-10, 11-15, and 16-20 years). Main Outcomes and Measures: Overall and stratum-specific adjusted estimated MIS-C incidence per 1000000 person-months and per 1000000 SARS-CoV-2 infections. Results: In the 7 jurisdictions examined, 248 persons with MIS-C were reported (median [interquartile range] age, 8 [4-13] years; 133 [53.6%] male; 96 persons [38.7%] were Hispanic or Latino; 75 persons [30.2%] were Black). The incidence of MIS-C per 1000000 person-months was 5.1 (95% CI, 4.5-5.8) persons. Compared with White persons, incidence per 1000000 person-months was higher among Black persons (adjusted incidence rate ratio [aIRR], 9.26 [95% CI, 6.15-13.93]), Hispanic or Latino persons (aIRR, 8.92 [95% CI, 6.00-13.26]), and Asian or Pacific Islander (aIRR, 2.94 [95% CI, 1.49-5.82]) persons. MIS-C incidence per 1000000 SARS-CoV-2 infections was 316 (95% CI, 278-357) persons and was higher among Black (aIRR, 5.62 [95% CI, 3.68-8.60]), Hispanic or Latino (aIRR, 4.26 [95% CI, 2.85-6.38]), and Asian or Pacific Islander persons (aIRR, 2.88 [95% CI, 1.42-5.83]) compared with White persons. For both analyses, incidence was highest among children aged 5 years or younger (4.9 [95% CI, 3.7-6.6] children per 1000000 person-months) and children aged 6 to 10 years (6.3 [95% CI, 4.8-8.3] children per 1000000 person-months). Conclusions and Relevance: In this cohort study, MIS-C was a rare complication associated with SARS-CoV-2 infection. Estimates for population-based incidence and incidence among persons with infection were higher among Black, Hispanic or Latino, and Asian or Pacific Islander persons. Further study is needed to understand variability by race/ethnicity and age group..

Original language	English (US)
Article number	e2116420
Journal	JAMA network open
Volume	4
Issue number	6
DOIs	https://doi.org/10.1001/jamanetworkopen.2021.16420
State	Published - Jun 10 2021

All Science Journal Classification (ASJC) codes

General Medicine

Access to Document

10.1001/jamanetworkopen.2021.16420

Cite this

Payne, A. B., Gilani, Z., Godfred-Cato, S., Belay, E. D., Feldstein, L. R., Patel, M. M., Randolph, A. G., Newhams, M., Thomas, D., Magleby, R., Hsu, K., Burns, M., Dufort, E., Maxted, A., Pietrowski, M., Longenberger, A., Bidol, S., Henderson, J., Sosa, L., ... Cholette, J. M. (2021). Incidence of Multisystem Inflammatory Syndrome in Children among US Persons Infected with SARS-CoV-2. JAMA network open, 4(6), Article e2116420. https://doi.org/10.1001/jamanetworkopen.2021.16420

@article{7d44b560724e4319a75c4aa38b91877c,

title = "Incidence of Multisystem Inflammatory Syndrome in Children among US Persons Infected with SARS-CoV-2",

abstract = "Importance: Multisystem inflammatory syndrome in children (MIS-C) is associated with recent or current SARS-CoV-2 infection. Information on MIS-C incidence is limited. Objective: To estimate population-based MIS-C incidence per 1000000 person-months and to estimate MIS-C incidence per 1000000 SARS-CoV-2 infections in persons younger than 21 years. Design, Setting, and Participants: This cohort study used enhanced surveillance data to identify persons with MIS-C during April to June 2020, in 7 jurisdictions reporting to both the Centers for Disease Control and Prevention national surveillance and to Overcoming COVID-19, a multicenter MIS-C study. Denominators for population-based estimates were derived from census estimates; denominators for incidence per 1000000 SARS-CoV-2 infections were estimated by applying published age- and month-specific multipliers accounting for underdetection of reported COVID-19 case counts. Jurisdictions included Connecticut, Georgia, Massachusetts, Michigan, New Jersey, New York (excluding New York City), and Pennsylvania. Data analyses were conducted from August to December 2020. Exposures: Race/ethnicity, sex, and age group (ie, ≤5, 6-10, 11-15, and 16-20 years). Main Outcomes and Measures: Overall and stratum-specific adjusted estimated MIS-C incidence per 1000000 person-months and per 1000000 SARS-CoV-2 infections. Results: In the 7 jurisdictions examined, 248 persons with MIS-C were reported (median [interquartile range] age, 8 [4-13] years; 133 [53.6%] male; 96 persons [38.7%] were Hispanic or Latino; 75 persons [30.2%] were Black). The incidence of MIS-C per 1000000 person-months was 5.1 (95% CI, 4.5-5.8) persons. Compared with White persons, incidence per 1000000 person-months was higher among Black persons (adjusted incidence rate ratio [aIRR], 9.26 [95% CI, 6.15-13.93]), Hispanic or Latino persons (aIRR, 8.92 [95% CI, 6.00-13.26]), and Asian or Pacific Islander (aIRR, 2.94 [95% CI, 1.49-5.82]) persons. MIS-C incidence per 1000000 SARS-CoV-2 infections was 316 (95% CI, 278-357) persons and was higher among Black (aIRR, 5.62 [95% CI, 3.68-8.60]), Hispanic or Latino (aIRR, 4.26 [95% CI, 2.85-6.38]), and Asian or Pacific Islander persons (aIRR, 2.88 [95% CI, 1.42-5.83]) compared with White persons. For both analyses, incidence was highest among children aged 5 years or younger (4.9 [95% CI, 3.7-6.6] children per 1000000 person-months) and children aged 6 to 10 years (6.3 [95% CI, 4.8-8.3] children per 1000000 person-months). Conclusions and Relevance: In this cohort study, MIS-C was a rare complication associated with SARS-CoV-2 infection. Estimates for population-based incidence and incidence among persons with infection were higher among Black, Hispanic or Latino, and Asian or Pacific Islander persons. Further study is needed to understand variability by race/ethnicity and age group..",

author = "Payne, {Amanda B.} and Zunera Gilani and Shana Godfred-Cato and Belay, {Ermias D.} and Feldstein, {Leora R.} and Patel, {Manish M.} and Randolph, {Adrienne G.} and Margaret Newhams and Deepam Thomas and Reed Magleby and Katherine Hsu and Meagan Burns and Elizabeth Dufort and Angie Maxted and Michael Pietrowski and Allison Longenberger and Sally Bidol and Justin Henderson and Lynn Sosa and Alexandra Edmundson and Melissa Tobin-D'Angelo and Laura Edison and Sabrina Heidemann and Singh, {Aalok R.} and Giuliano, {John S.} and Kleinman, {Lawrence C.} and Tarquinio, {Keiko M.} and Walsh, {Rowan F.} and Fitzgerald, {Julie C.} and Clouser, {Katharine N.} and Gertz, {Shira J.} and Carroll, {Ryan W.} and Carroll, {Christopher L.} and Hoots, {Brooke E.} and Carrie Reed and Dahlgren, {F. Scott} and Oster, {Matthew E.} and Pierce, {Timmy J.} and Curns, {Aaron T.} and Langley, {Gayle E.} and Campbell, {Angela P.} and Neha Balachandran and Murray, {Thomas S.} and Cole Burkholder and Troy Brancard and Jenna Lifshitz and Dylan Leach and Ian Charpie and Cory Tice and Coffin, {Susan E.} and Dana Perella and Kaitlin Jones and Marohn, {Kimberly L.} and Yager, {Phoebe H.} and Fernandes, {Neil D.} and Flori, {Heidi R.} and Koncicki, {Monica L.} and Walker, {Karen S.} and {Di Pentima}, {Maria Cecilia} and Simon Li and Horwitz, {Steven M.} and Sunanda Gaur and Coffey, {Dennis C.} and Ilana Harwayne-Gidansky and Hymes, {Saul R.} and Thomas, {Neal J.} and Ackerman, {Kate G.} and Cholette, {Jill M.}",

year = "2021",

month = jun,

day = "10",

doi = "10.1001/jamanetworkopen.2021.16420",

language = "English (US)",

volume = "4",

journal = "JAMA network open",

issn = "2574-3805",

publisher = "American Medical Association",

number = "6",

}

Payne, AB, Gilani, Z, Godfred-Cato, S, Belay, ED, Feldstein, LR, Patel, MM, Randolph, AG, Newhams, M, Thomas, D, Magleby, R, Hsu, K, Burns, M, Dufort, E, Maxted, A, Pietrowski, M, Longenberger, A, Bidol, S, Henderson, J, Sosa, L, Edmundson, A, Tobin-D'Angelo, M, Edison, L, Heidemann, S, Singh, AR, Giuliano, JS, Kleinman, LC, Tarquinio, KM, Walsh, RF, Fitzgerald, JC, Clouser, KN, Gertz, SJ, Carroll, RW, Carroll, CL, Hoots, BE, Reed, C, Dahlgren, FS, Oster, ME, Pierce, TJ, Curns, AT, Langley, GE, Campbell, AP, Balachandran, N, Murray, TS, Burkholder, C, Brancard, T, Lifshitz, J, Leach, D, Charpie, I, Tice, C, Coffin, SE, Perella, D, Jones, K, Marohn, KL, Yager, PH, Fernandes, ND, Flori, HR, Koncicki, ML, Walker, KS, Di Pentima, MC, Li, S, Horwitz, SM, Gaur, S, Coffey, DC, Harwayne-Gidansky, I, Hymes, SR, Thomas, NJ, Ackerman, KG & Cholette, JM 2021, 'Incidence of Multisystem Inflammatory Syndrome in Children among US Persons Infected with SARS-CoV-2', JAMA network open, vol. 4, no. 6, e2116420. https://doi.org/10.1001/jamanetworkopen.2021.16420

TY - JOUR

T1 - Incidence of Multisystem Inflammatory Syndrome in Children among US Persons Infected with SARS-CoV-2

AU - Payne, Amanda B.

AU - Gilani, Zunera

AU - Godfred-Cato, Shana

AU - Belay, Ermias D.

AU - Feldstein, Leora R.

AU - Patel, Manish M.

AU - Randolph, Adrienne G.

AU - Newhams, Margaret

AU - Thomas, Deepam

AU - Magleby, Reed

AU - Hsu, Katherine

AU - Burns, Meagan

AU - Dufort, Elizabeth

AU - Maxted, Angie

AU - Pietrowski, Michael

AU - Longenberger, Allison

AU - Bidol, Sally

AU - Henderson, Justin

AU - Sosa, Lynn

AU - Edmundson, Alexandra

AU - Tobin-D'Angelo, Melissa

AU - Edison, Laura

AU - Heidemann, Sabrina

AU - Singh, Aalok R.

AU - Giuliano, John S.

AU - Kleinman, Lawrence C.

AU - Tarquinio, Keiko M.

AU - Walsh, Rowan F.

AU - Fitzgerald, Julie C.

AU - Clouser, Katharine N.

AU - Gertz, Shira J.

AU - Carroll, Ryan W.

AU - Carroll, Christopher L.

AU - Hoots, Brooke E.

AU - Reed, Carrie

AU - Dahlgren, F. Scott

AU - Oster, Matthew E.

AU - Pierce, Timmy J.

AU - Curns, Aaron T.

AU - Langley, Gayle E.

AU - Campbell, Angela P.

AU - Balachandran, Neha

AU - Murray, Thomas S.

AU - Burkholder, Cole

AU - Brancard, Troy

AU - Lifshitz, Jenna

AU - Leach, Dylan

AU - Charpie, Ian

AU - Tice, Cory

AU - Coffin, Susan E.

AU - Perella, Dana

AU - Jones, Kaitlin

AU - Marohn, Kimberly L.

AU - Yager, Phoebe H.

AU - Fernandes, Neil D.

AU - Flori, Heidi R.

AU - Koncicki, Monica L.

AU - Walker, Karen S.

AU - Di Pentima, Maria Cecilia

AU - Li, Simon

AU - Horwitz, Steven M.

AU - Gaur, Sunanda

AU - Coffey, Dennis C.

AU - Harwayne-Gidansky, Ilana

AU - Hymes, Saul R.

AU - Thomas, Neal J.

AU - Ackerman, Kate G.

AU - Cholette, Jill M.

PY - 2021/6/10

Y1 - 2021/6/10

N2 - Importance: Multisystem inflammatory syndrome in children (MIS-C) is associated with recent or current SARS-CoV-2 infection. Information on MIS-C incidence is limited. Objective: To estimate population-based MIS-C incidence per 1000000 person-months and to estimate MIS-C incidence per 1000000 SARS-CoV-2 infections in persons younger than 21 years. Design, Setting, and Participants: This cohort study used enhanced surveillance data to identify persons with MIS-C during April to June 2020, in 7 jurisdictions reporting to both the Centers for Disease Control and Prevention national surveillance and to Overcoming COVID-19, a multicenter MIS-C study. Denominators for population-based estimates were derived from census estimates; denominators for incidence per 1000000 SARS-CoV-2 infections were estimated by applying published age- and month-specific multipliers accounting for underdetection of reported COVID-19 case counts. Jurisdictions included Connecticut, Georgia, Massachusetts, Michigan, New Jersey, New York (excluding New York City), and Pennsylvania. Data analyses were conducted from August to December 2020. Exposures: Race/ethnicity, sex, and age group (ie, ≤5, 6-10, 11-15, and 16-20 years). Main Outcomes and Measures: Overall and stratum-specific adjusted estimated MIS-C incidence per 1000000 person-months and per 1000000 SARS-CoV-2 infections. Results: In the 7 jurisdictions examined, 248 persons with MIS-C were reported (median [interquartile range] age, 8 [4-13] years; 133 [53.6%] male; 96 persons [38.7%] were Hispanic or Latino; 75 persons [30.2%] were Black). The incidence of MIS-C per 1000000 person-months was 5.1 (95% CI, 4.5-5.8) persons. Compared with White persons, incidence per 1000000 person-months was higher among Black persons (adjusted incidence rate ratio [aIRR], 9.26 [95% CI, 6.15-13.93]), Hispanic or Latino persons (aIRR, 8.92 [95% CI, 6.00-13.26]), and Asian or Pacific Islander (aIRR, 2.94 [95% CI, 1.49-5.82]) persons. MIS-C incidence per 1000000 SARS-CoV-2 infections was 316 (95% CI, 278-357) persons and was higher among Black (aIRR, 5.62 [95% CI, 3.68-8.60]), Hispanic or Latino (aIRR, 4.26 [95% CI, 2.85-6.38]), and Asian or Pacific Islander persons (aIRR, 2.88 [95% CI, 1.42-5.83]) compared with White persons. For both analyses, incidence was highest among children aged 5 years or younger (4.9 [95% CI, 3.7-6.6] children per 1000000 person-months) and children aged 6 to 10 years (6.3 [95% CI, 4.8-8.3] children per 1000000 person-months). Conclusions and Relevance: In this cohort study, MIS-C was a rare complication associated with SARS-CoV-2 infection. Estimates for population-based incidence and incidence among persons with infection were higher among Black, Hispanic or Latino, and Asian or Pacific Islander persons. Further study is needed to understand variability by race/ethnicity and age group..

AB - Importance: Multisystem inflammatory syndrome in children (MIS-C) is associated with recent or current SARS-CoV-2 infection. Information on MIS-C incidence is limited. Objective: To estimate population-based MIS-C incidence per 1000000 person-months and to estimate MIS-C incidence per 1000000 SARS-CoV-2 infections in persons younger than 21 years. Design, Setting, and Participants: This cohort study used enhanced surveillance data to identify persons with MIS-C during April to June 2020, in 7 jurisdictions reporting to both the Centers for Disease Control and Prevention national surveillance and to Overcoming COVID-19, a multicenter MIS-C study. Denominators for population-based estimates were derived from census estimates; denominators for incidence per 1000000 SARS-CoV-2 infections were estimated by applying published age- and month-specific multipliers accounting for underdetection of reported COVID-19 case counts. Jurisdictions included Connecticut, Georgia, Massachusetts, Michigan, New Jersey, New York (excluding New York City), and Pennsylvania. Data analyses were conducted from August to December 2020. Exposures: Race/ethnicity, sex, and age group (ie, ≤5, 6-10, 11-15, and 16-20 years). Main Outcomes and Measures: Overall and stratum-specific adjusted estimated MIS-C incidence per 1000000 person-months and per 1000000 SARS-CoV-2 infections. Results: In the 7 jurisdictions examined, 248 persons with MIS-C were reported (median [interquartile range] age, 8 [4-13] years; 133 [53.6%] male; 96 persons [38.7%] were Hispanic or Latino; 75 persons [30.2%] were Black). The incidence of MIS-C per 1000000 person-months was 5.1 (95% CI, 4.5-5.8) persons. Compared with White persons, incidence per 1000000 person-months was higher among Black persons (adjusted incidence rate ratio [aIRR], 9.26 [95% CI, 6.15-13.93]), Hispanic or Latino persons (aIRR, 8.92 [95% CI, 6.00-13.26]), and Asian or Pacific Islander (aIRR, 2.94 [95% CI, 1.49-5.82]) persons. MIS-C incidence per 1000000 SARS-CoV-2 infections was 316 (95% CI, 278-357) persons and was higher among Black (aIRR, 5.62 [95% CI, 3.68-8.60]), Hispanic or Latino (aIRR, 4.26 [95% CI, 2.85-6.38]), and Asian or Pacific Islander persons (aIRR, 2.88 [95% CI, 1.42-5.83]) compared with White persons. For both analyses, incidence was highest among children aged 5 years or younger (4.9 [95% CI, 3.7-6.6] children per 1000000 person-months) and children aged 6 to 10 years (6.3 [95% CI, 4.8-8.3] children per 1000000 person-months). Conclusions and Relevance: In this cohort study, MIS-C was a rare complication associated with SARS-CoV-2 infection. Estimates for population-based incidence and incidence among persons with infection were higher among Black, Hispanic or Latino, and Asian or Pacific Islander persons. Further study is needed to understand variability by race/ethnicity and age group..

UR - http://www.scopus.com/inward/record.url?scp=85108105399&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85108105399&partnerID=8YFLogxK

U2 - 10.1001/jamanetworkopen.2021.16420

DO - 10.1001/jamanetworkopen.2021.16420

M3 - Article

C2 - 34110391

AN - SCOPUS:85108105399

SN - 2574-3805

VL - 4

JO - JAMA network open

JF - JAMA network open

IS - 6

M1 - e2116420

ER -

Incidence of Multisystem Inflammatory Syndrome in Children among US Persons Infected with SARS-CoV-2

Abstract

All Science Journal Classification (ASJC) codes

Access to Document

Other files and links

Fingerprint

Cite this