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
Publication date
2023-12-01
Authors
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.
Editors
Advisors
Supervisors
Document Type
Article
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License
cc_by_nc_nd
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 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.
Keywords
COVID-19, MIS-C, pediatrics, real-time reporting, SARS-CoV-2, Pediatrics, Perinatology, and Child Health, Microbiology (medical), Infectious Diseases
Citation
Tulling, A J, Lugthart, G, Mooij, M G, Brackel, C L H, Terheggen-Lagro, S W J, Oostenbrink, R, Buysse, C M P, Hashimoto, S, Armbrust, W, Bannier, M A G E, Bekhof, J, Van Gameren-Oosterom, H B, Hendriks, H, Van Houten, M A, Van Der Linden, J W, Lebon, A, Van Onzenoort-Bokken, L, Tramper-Stranders, G A, Van Veen, M, Von Asmuth, E G J, Buddingh, E P, Van Der Aa, L B, Van Aerde, K J, Auffarth-Smedema, B, Bart, I Y, Beek, C, Bechan, G I, Van Den Berg, J M, Boonstra, V H, Breukels, M, Brinkman, D M C, Bruijning-Verhagen, P C J L, De Crom, S C, Ernst-Kruis, M R, Fraaij, P L A, Goris, J, Groeneweg, M, Gruppen, M, Hammer, S C, Hissink Muller, P C E, Homan-Van Der Veen, J, Jacobs, M A M, Kamps, A W A, Ketharanathan, N, Van Der Kuip, M, Kuijpers, T W, Legger, E G, Lo-A-Njoe, S, Manshande, M E, Miedema, C J, Obihara, C C, Olivieira, G O, Oudshoorn, A, Peeters, E J E, Petru, R, Pijnenburg, M W H, Rook, D, Schilleman, K, Schopmeijer, R, Slotboom, D, Van Der Steen, M, Stol, K, Thomasse, Y E M, Tissing, W J E, Van Den Tweel, X W, Vastert, S J, Verbeek, A B, Vernooij-Van Langen, A M M, Wieringa, J W, Wildenbeest, J G, De Wildt, S N & Van Woerden, C 2023, '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', Pediatric Infectious Disease Journal, vol. 42, no. 12, pp. 1077-1085. https://doi.org/10.1097/INF.0000000000004098