Multisystem Inflammatory Syndrome in Children in Western Countries? Decreasing Incidence as the Pandemic Progresses?: An Observational Multicenter International Cross-sectional Study
Danilo Buonsenso, Aida Perramon‐Malavez, Martí Català, Juan Pablo Torres, Germán Camacho‐Moreno, Mariela Rojas-Solano, Rolando Ulloa‐Gutiérrez, Kattia Camacho-Badilla, Cristian Pérez-Corrales, Nicola Cotugno, Marco Antonio Yamazaki‐Nakashimada, Dora Estripeaut, Emilie P. Buddingh, Erik von Asmuth, Annemarie M. C. van Rossum, Pere Soler‐Palacín, Jacques G. Rivière, Clara Prats, Rosa Pino, Fernando Paredes-Carmona, Núria Visa-Reñé, Alberto García‐Salido, A. Martínez, Antoni Soriano‐Arandes
Abstract
BACKGROUND: SARS-CoV-2 variations as well as immune protection after previous infections and/or vaccination may have altered the incidence of multisystemic inflammatory syndrome in children (MIS-C). We aimed to report an international time-series analysis of the incidence of MIS-C to determine if there was a shift in the regions or countries included into the study. METHODS: This is a multicenter, international, cross-sectional study. We collected the MIS-C incidence from the participant regions and countries for the period July 2020 to November 2021. We assessed the ratio between MIS-C cases and COVID-19 pediatric cases in children <18 years diagnosed 4 weeks earlier (average time for the temporal association observed in this disease) for the study period. We performed a binomial regression analysis for 8 participating sites [Bogotá (Colombia), Chile, Costa Rica, Lazio (Italy), Mexico DF, Panama, The Netherlands and Catalonia (Spain)]. RESULTS: We included 904 cases of MIS-C, among a reference population of 17,906,432 children. We estimated a global significant decrease trend ratio in MIS-C cases/COVID-19 diagnosed cases in the previous month ( P < 0.001). When analyzing separately each of the sites, Chile and The Netherlands maintained a significant decrease trend ( P < 0.001), but this ratio was not statistically significant for the rest of sites. CONCLUSIONS: To our knowledge, this is the first international study describing a global reduction in the trend of the MIS-C incidence during the pandemic. COVID-19 vaccination and other factors possibly linked to the virus itself and/or community transmission may have played a role in preventing new MIS-C cases.