Incidence of Multisystem Inflammatory Syndrome in Children Among US Persons Infected With SARS-CoV-2

Accepted for Publication: May 4, 2021.

Published: June 10, 2021. doi:10.1001/jamanetworkopen.2021.16420

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Payne AB et al. JAMA Network Open.

Corresponding Author: Angela P. Campbell, MD, MPH, COVID-19 Response Team, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, MS H24-5, Atlanta, GA 30329 (app4@cdc.gov).

Author Contributions: Drs Payne and Campbell had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Payne, Gilani, Randolph, Dufort, Maxted, Edison, Kleinman, Hoots, Reed, Curns, Langley, Campbell, Flori.

Acquisition, analysis, or interpretation of data: Payne, Gilani, Godfred-Cato, Belay, Feldstein, Patel, Randolph, Newhams, D. Thomas, Magleby, Hsu, Burns, Dufort, Maxted, Pietrowski, Longenberger, Bidol, Henderson, Sosa, Edmundson, Tobin-D'Angelo, Heidemann, Singh, Giuliano, Kleinman, Tarquinio, Walsh, Fitzgerald, Clouser, Gertz, R. W. Carroll, C. L. Carroll, Hoots, Reed, Dahlgren, Oster, Pierce, Curns, Campbell, Balachandran, Murray, Burkholder, Brancard, Lifshitz, Leach, Charpie, Tice, Coffin, Perella, Jones, Marohn, Yager, Fernandes, Flori, Koncicki, Walker, Di Pentima, Li, Horwitz, Gaur, Coffey, Harwayne-Gidansky, Hymes, N. J. Thomas, Ackerman, Cholette.

Drafting of the manuscript: Payne, Gilani, Singh, Pierce, Campbell, Harwayne-Gidansky.

Critical revision of the manuscript for important intellectual content: Payne, Gilani, Godfred-Cato, Belay, Feldstein, Patel, Randolph, Newhams, D. Thomas, Magleby, Hsu, Burns, Dufort, Maxted, Pietrowski, Longenberger, Bidol, Henderson, Sosa, Edmundson, Tobin-D'Angelo, Edison, Heidemann, Singh, Giuliano, Kleinman, Tarquinio, Walsh, Fitzgerald, Clouser, Gertz, R. W. Carroll, C. L. Carroll, Hoots, Reed, Dahlgren, Oster, Curns, Langley, Campbell, Balachandran, Murray, Burkholder, Brancard, Lifshitz, Leach, Charpie, Tice, Coffin, Perella, Jones, Marohn, Yager, Fernandes, Flori, Koncicki, Walker, Di Pentima, Li, Horwitz, Gaur, Coffey, Harwayne-Gidansky, Hymes, N. J. Thomas, Ackerman, Cholette.

Statistical analysis: Payne, Magleby, Sosa, Reed, Dahlgren, Brancard, Leach, Charpie, Tice, Perella.

Obtained funding: Randolph, Walsh.

Administrative, technical, or material support: Gilani, Godfred-Cato, Feldstein, Patel, Randolph, Newhams, D. Thomas, Henderson, Fitzgerald, Gertz, R. W. Carroll, C. L. Carroll, Hoots, Oster, Curns, Campbell, Balachandran, Murray, Burkholder, Tice, Coffin, Perella, Yager, Fernandes, Flori, Di Pentima, Gaur, Hymes.

Supervision: Belay, Randolph, Edison, Singh, Giuliano, Kleinman, Gertz, Hoots, Langley, Campbell, Coffin, Perella, N. J. Thomas.

Conflict of Interest Disclosures: Dr Randolph reported receiving grants from the Centers for Disease Control and Prevention (CDC) during the conduct of this study and personal fees from UpToDate and serving as a scientific advisor for LaJolla Pharma outside the submitted work. Ms Newhams reported receiving grants from the CDC during the conduct of the study. Ms Bidol reported receiving grants from the CDC during the conduct of the study. Mr Henderson reported receiving grants from the CDC during the conduct of this study. Dr Heidemann reported grants from NIH during the conduct of the study. Dr Singh reported grants from CDC during the conduct of the study. Dr Giuliano reported receiving grants from the CDC during the conduct of the study. Dr Kleinman reported receiving grants from the CDC during the conduct of the study and owning stock in Regeneron, GlaxoSmithKline, Sanofi, Amgen. Dr Tarquinio reported receiving grants from the CDC. Dr Walsh reported receiving grants from the CDC during the conduct of the study. Dr Fitzgerald receiving reported grants from the CDC and National Institute of Diabetes and Digestive and Kidney Diseases during the conduct of the study. Dr Gertz reported receiving grants from the CDC during the conduct of the study. Dr R. W. Carroll reported receiving personal fees from EDCTP and Unitaid outside the submitted work. Dr Coffin reported receiving grants from and serving on a data and safety monitoring board for Merck & Co. and serving as a consultant for Genentech outside the submitted work. Ms Perella reported receiving grants from the CDC outside the submitted work. Ms Jones reported receiving grants from CDC during the conduct of the study. Dr Flori reported receiving grants from the National Heart, Lung and Blood Institute and Eunice Kennedy Shriver National Institute of Child Health and Human Development, serving on committees for the Society for Critical Care Medicine Sepsis, Michigan Thoracic Society, and Pediatric Acute Lung Injury and Sepsis Investigators Network outside the submitted work. Dr N. J. Thomas reported receiving grants from the CDC during the conduct of the study. No other disclosures were reported.

Funding/Support: The Overcoming COVID-19 study was funded by the CDC under a contract to Boston Children’s Hospital. All participating jurisdictions received financial support from the CDC Prevention through the Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases cooperative agreement.

Role of the Funder/Sponsor: The funder participated in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, and approval of the manuscript; and decision to submit the manuscript for publication.

MIS-C Incidence Authorship Group: Neha Balachandran, MBBS, MPH; Thomas S. Murray, MD, PhD; Cole Burkholder, MPH; Troy Brancard, MPH; Jenna Lifshitz; Dylan Leach, MPH; Ian Charpie, MPH; Cory Tice, MPH; Susan E. Coffin, MD, MPH; Dana Perella, MPH; Kaitlin Jones, RN; Kimberly L. Marohn, MD; Phoebe H. Yager, MD; Neil D. Fernandes, MBBS; Heidi R. Flori, MD; Monica L. Koncicki, MD; Karen S. Walker, MD; Maria Cecilia Di Pentima, MD; Simon Li, MD, MPH; Steven M. Horwitz, MD; Sunanda Gaur, MD; Dennis C. Coffey, MD; Ilana Harwayne-Gidansky, MD; Saul R. Hymes, MD; Neal J. Thomas, MD, MSc; Kate G. Ackerman, MD, MPH; Jill M. Cholette, MD.

Affiliations of MIS-C Incidence Authorship Group: COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia (Balachandran); New Jersey Department of Health, Trenton (Brancard, Lifshitz); Massachusetts Department of Health, Boston (Leach, Charpie); New York State Department of Health, Albany (Tice); Philadelphia Department of Public Health, Philadelphia, Pennsylvania (Coffin, Perella); Michigan Department of Health and Human Services, Lansing (Burkholder); Department of Pediatrics, Infectious Disease and Global Health, Yale School of Medicine, New Haven, Connecticut (Murray); Emory University School of Medicine, Children’s Healthcare of Atlanta, Atlanta, Georgia (Jones); Baystate Children’s Hospital, Springfield, Massachusetts (Marohn); MassGeneral Hospital for Children, Harvard Medical School, Boston, Massachusetts (Yager, Fernandes); University of Michigan CS Mott Children’s Hospital, Ann Arbor (Flori); St Christopher’s Hospital for Children, Philadelphia, Pennsylvania (Koncicki); Cooper University Hospital, Camden, New Jersey (Walker); Goryeb Children’s Hospital, Morristown, New Jersey (Di Pentima); Bristol-Myers Squibb Children’s Hospital, New Brunswick, New Jersey (Li, Horwitz, Gaur); The Valley Hospital, Ridgewood, New Jersey (Coffey); Stony Brook University Hospital, Stony Brook, New York (Harwayne-Gidansky, Hymes); Penn State Children’s Hospital, Hershey, Pennsylvania (Thomas); Golisano Children’s Hospital, Rochester, New York (Ackerman, Cholette).

Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the US Centers for Disease Control and Prevention.

Additional Contributions: Jihong Yao, MEng (New Jersey Department of Health); Stella Tsai, PhD (New Jersey Department of Health); Wendy Pulver, MS (New York State Department of Health); Debra Blog, MD (New York State Department of Health); Elina Paul, MPH (Children’s Hospital of Philadelphia); Patricia Hennessey, RN, BSN, MSN (St. Christopher’s Hospital for Children); Bryce Spiker, MPH (Michigan Department of Health and Human Services); Libby Reeg, MPH (Michigan Department of Health and Human Services); Tiffany Henderson, MPH (Michigan Department of Health and Human Services); Makayla Murphy, BA (Connecticut Children’s); Juan C. Salazar, MD, MPH (Connecticut Children’s); Kathy Krechevsky, MT (Yale-New Haven Hospital); Christina Murdzek, MHS (Yale-New Haven Hospital); Siri Wilson, MPH (Georgia Department of Public Health); Kristina Lam, MD, MPH (Georgia Department of Public Health); John Olmstead, MPH (Georgia Department of Public Health; Council of State and Territorial Epidemiologists) assisted in data collection for this study. These individuals were not compensated for this work beyond their usual salaries.