Severe Pediatric COVID-19 and Multisystem Inflammatory Syndrome in Children from Wild-type to Population Immunity: A Prospective Multicenter Cohort Study with Real-time Reporting
Tulling, Adam J.; Lugthart, Gertjan; Mooij, Miriam G.; Brackel, Caroline L.H.; Terheggen-Lagro, Suzanne W.J.; Oostenbrink, Rianne; Buysse, Corinne M.P.; Hashimoto, Simone; Armbrust, Wineke; Bannier, Michiel A.G.E.; Bekhof, Jolita; Van Gameren-Oosterom, Helma B.; Hendriks, Han; Van Houten, Marlies A.; Van Der Linden, Jan W.; Lebon, Ankie; Van Onzenoort-Bokken, Lonneke; Tramper-Stranders, Gerdien A.; Van Veen, Mirjam; Von Asmuth, Erik G.J.; Buddingh, Emilie P.; Van Der Aa, Leontien B.; Van Aerde, Koen J.; Auffarth-Smedema, Bettina; Bart, Ingeborg Y.; Beek, Cherise; Bechan, Gitanjali I.; Van Den Berg, J. Merlijn; Boonstra, Venje H.; Breukels, Mijke; Brinkman, Danielle M.C.; Bruijning-Verhagen, Patricia C.J.L.; De Crom, Stephanie C.; Ernst-Kruis, Margot R.; Fraaij, Pieter L.A.; Goris, Joyce; Groeneweg, Michael; Gruppen, Mariken; Hammer, Sanne C.; Hissink Muller, Petra C.E.; Homan-Van Der Veen, Jenneke; Jacobs, Monique A.M.; Kamps, Arvid W.A.; Ketharanathan, Naomi; Van Der Kuip, Martijn; Kuijpers, Taco W.; Legger, Elizabeth G.; Lo-A-Njoe, Shirley; Manshande, Meindert E.; Miedema, Carien J.; Obihara, Charlie C.; Olivieira, Gideon O.; Oudshoorn, Annemarie; Peeters, Esther J.E.; Petru, Ronald; Pijnenburg, Marielle W.H.; Rook, Denise; Schilleman, Kim; Schopmeijer, Rian; Slotboom, David; Van Der Steen, Manouk; Stol, Kim; Thomasse, Yolande E.M.; Tissing, Wim J.E.; Van Den Tweel, Xandra W.; Vastert, Sebastiaan J.; Verbeek, Anne B.; Vernooij-Van Langen, Annette M.M.; Wieringa, Jantien W.; Wildenbeest, Joanne G.; De Wildt, Saskia N.; Van Woerden, Christiaan
(2023) Pediatric Infectious Disease Journal, volume 42, issue 12, pp. 1077 - 1085
(Article)
Abstract
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
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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.
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Keywords: COVID-19, MIS-C, pediatrics, real-time reporting, SARS-CoV-2, Pediatrics, Perinatology, and Child Health, Microbiology (medical), Infectious Diseases
ISSN: 0891-3668
Publisher: Lippincott Williams & Wilkins
Note: Publisher Copyright: © 2023 Lippincott Williams and Wilkins. All rights reserved.
(Peer reviewed)