Characteristics and Outcomes of US Children and Adolescents With Multisystem Inflammatory Syndrome in Children (MIS-C) Compared With Severe Acute COVID-19

February 24, 2021

Leora R. Feldstein, PhD; Mark W. Tenforde, MD; Kevin G. Friedman, MD; Margaret Newhams, MPH; Erica Billig Rose, PhD; Heda Dapul, MD; Vijaya L. Soma, MD; Aline B. Maddux, MD; Peter M. Mourani, MD; Cindy Bowens, MD; Mia Maamari, MD; Mark W. Hall, MD; Becky J. Riggs, MD; John S. Giuliano Jr, MD; Aalok R. Singh, MD; Simon Li, MD; Michele Kong, MD; Jennifer E. Schuster, MD; Gwenn E. McLaughlin, MD; Stephanie P. Schwartz, MD; Tracie C. Walker, MD; Laura L. Loftis, MD; Charlotte V. Hobbs, MD; Natasha B. Halasa, MD; Sule Doymaz, MD; Christopher J. Babbitt, MD; Janet R. Hume, MD; Shira J. Gertz, MD; Katherine Irby, MD; Katharine N. Clouser, MD; Natalie Z. Cvijanovich, MD; Tamara T. Bradford, MD; Lincoln S. Smith, MD; Sabrina M. Heidemann, MD; Sheemon P. Zackai, MD; Kari Wellnitz, MD; Ryan A. Nofziger, MD; Steven M. Horwitz, MD; Ryan W. Carroll, MD; Courtney M. Rowan, MD; Keiko M. Tarquinio, MD; Elizabeth H. Mack, MD; Julie C. Fitzgerald, MD; Bria M. Coates, MD; Ashley M. Jackson, MPH; Cameron C. Young; Mary Beth F. Son, MD; Manish M. Patel, MD; Jane W. Newburger, MD; Adrienne G. Randolph, MD; for the Overcoming COVID-19 Investigators

JAMA Network

From March 15th to Oct 31st, 2020, investigators collected demographic and clinical data on patients ≤21 years old who had either clinically confirmed multisystem inflammatory syndrome in children (MIS-C) or PCR/antibody-confirmed severe acute COVID-19. A total of 1116 patients from 66 hospitals across 31 US states were included; 48% with MIS-C and 52% with COVID-19. Cardiorespiratory involvement was more common in patients with MIS-C compared to COVID-19 (56.0% vs 8.8%). Lab values revealed higher neutrophil to lymphocyte ratios, higher CRP levels and lower platelet counts in MIS-C patients as well. Fewer patients with COVID-19 were admitted to ICU (43.8% vs. 73.8%); however similar proportions of patients died in-hospital between groups (MIS-C: 1.9% vs. COVID-19: 1.4%). Overall, this national case series helps clinicians ascertain distinguishing features between COVID-19 in children/adolescents and MIS-C.

Davies NG, Abbott S, Barnard RC, et al. Estimated transmissibility and impact of SARS-CoV-2 lineage B.1.1.7 in England. Science 2021: eabg3055.

Partners