TY - JOUR
T1 - Severe Pediatric COVID-19 and Multisystem Inflammatory Syndrome in Children From Wild-type to Population Immunity
T2 - A Prospective Multicenter Cohort Study With Real-time Reporting
AU - Tulling, Adam J.
AU - Lugthart, Gertjan
AU - Mooij, Miriam G.
AU - Brackel, Caroline L. H.
AU - Terheggen-Lagro, Suzanne W. J.
AU - Oostenbrink, Rianne
AU - Buysse, Corinne M. P.
AU - Hashimoto, Simone
AU - Armbrust, Wineke
AU - Bannier, Michiel A. G. E.
AU - Bekhof, Jolita
AU - van Gameren-Oosterom, Helma B.
AU - Hendriks, Han
AU - van Houten, Marlies A.
AU - van der Linden, Jan W.
AU - Lebon, Ankie
AU - van Onzenoort-Bokken, Lonneke
AU - Tramper-Stranders, Gerdien A.
AU - COPP-study group
AU - van Veen, Mirjam
AU - von Asmuth, Erik G. J.
AU - Buddingh, Emilie P.
N1 - Funding Information:
This study was funded by the #wakeuptocorona crowdfund initiative of the Bontius Stichting and the Leiden University Fund, and by ZonMw (10430072110007 and 10430102110009). The study sponsors had no role in the design, collection, analysis and interpretation of data, nor in the writing of the report and in the submission.
Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.
PY - 2023/12/1
Y1 - 2023/12/1
N2 - BACKGROUND: SARS-CoV-2 variant evolution and increasing immunity altered the impact of pediatric SARS-CoV-2 infection. Public health decision-making relies on accurate and timely reporting of clinical data. METHODS: This international hospital-based multicenter, prospective cohort study with real-time reporting was active from March 2020 to December 2022. We evaluated longitudinal incident rates and risk factors for disease severity. RESULTS: We included 564 hospitalized children with acute COVID-19 (n = 375) or multisystem inflammatory syndrome in children (n = 189) from the Netherlands, Curaçao and Surinam. In COVID-19, 134/375 patients (36%) needed supplemental oxygen therapy and 35 (9.3%) required intensive care treatment. Age above 12 years and preexisting pulmonary conditions were predictors for severe COVID-19. During omicron, hospitalized children had milder disease. During population immunity, the incidence rate of pediatric COVID-19 infection declined for older children but was stable for children below 1 year. The incidence rate of multisystem inflammatory syndrome in children was highest during the delta wave and has decreased rapidly since omicron emerged. Real-time reporting of our data impacted national pediatric SARS-CoV-2 vaccination- and booster-policies. CONCLUSIONS: Our data supports the notion that similar to adults, prior immunity protects against severe sequelae of SARS-CoV-2 infections in children. Real-time reporting of accurate and high-quality data is feasible and impacts clinical and public health decision-making. The reporting framework of our consortium is readily accessible for future SARS-CoV-2 waves and other emerging infections.
AB - BACKGROUND: SARS-CoV-2 variant evolution and increasing immunity altered the impact of pediatric SARS-CoV-2 infection. Public health decision-making relies on accurate and timely reporting of clinical data. METHODS: This international hospital-based multicenter, prospective cohort study with real-time reporting was active from March 2020 to December 2022. We evaluated longitudinal incident rates and risk factors for disease severity. RESULTS: We included 564 hospitalized children with acute COVID-19 (n = 375) or multisystem inflammatory syndrome in children (n = 189) from the Netherlands, Curaçao and Surinam. In COVID-19, 134/375 patients (36%) needed supplemental oxygen therapy and 35 (9.3%) required intensive care treatment. Age above 12 years and preexisting pulmonary conditions were predictors for severe COVID-19. During omicron, hospitalized children had milder disease. During population immunity, the incidence rate of pediatric COVID-19 infection declined for older children but was stable for children below 1 year. The incidence rate of multisystem inflammatory syndrome in children was highest during the delta wave and has decreased rapidly since omicron emerged. Real-time reporting of our data impacted national pediatric SARS-CoV-2 vaccination- and booster-policies. CONCLUSIONS: Our data supports the notion that similar to adults, prior immunity protects against severe sequelae of SARS-CoV-2 infections in children. Real-time reporting of accurate and high-quality data is feasible and impacts clinical and public health decision-making. The reporting framework of our consortium is readily accessible for future SARS-CoV-2 waves and other emerging infections.
KW - COVID-19
KW - MIS-C
KW - SARS-CoV-2
KW - pediatrics
KW - real-time reporting
UR - https://www.scopus.com/pages/publications/85177103178
U2 - 10.1097/INF.0000000000004098
DO - 10.1097/INF.0000000000004098
M3 - Article
C2 - 37823702
SN - 0891-3668
VL - 42
SP - 1077
EP - 1085
JO - Pediatric infectious disease journal
JF - Pediatric infectious disease journal
IS - 12
ER -
SDG 3 Good Health and Well-being