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Severity and Incidence of Multisystem Inflammatory Syndrome in Children During 3 SARS-CoV-2 Pandemic Waves in Israel

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

Multisystem inflammatory syndrome in children (MIS-C) is a serious complication of SARS-CoV-2 infection.1 A previous study that described MIS-C cases in the first 3 waves of the COVID-19 pandemic found that the proportion of individuals with severe illness declined after the first wave.2 In Israel, the Omicron (B.1.1.529) variant started to spread in November 2021.3 We describe outcomes of MIS-C in a multicenter cohort and assessed incidence nationally during the Alpha, Delta, and Omicron variant waves.

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Article Information

Accepted for Publication: April 27, 2022.

Published Online: May 19, 2022. doi:10.1001/jama.2022.8025

Corresponding Author: Itai Shavit, MD, PO Box 274, Kibbutz Maayan Tzvi 3080500, Israel (itai@pem-database.org).

Author Contributions: Drs Levy and Shavit 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: Levy, Kaplan, Shavit.

Acquisition, analysis, or interpretation of data: Levy, Koppel, Yechiam, Shahar-Nissan, Kuchinski Cohen.

Drafting of the manuscript: Levy, Kaplan, Yechiam, Kuchinski Cohen, Shavit.

Critical revision of the manuscript for important intellectual content: Levy, Koppel, Kaplan, Shahar-Nissan, Kuchinski Cohen.

Statistical analysis: Shavit.

Administrative, technical, or material support: Koppel, Kaplan, Yechiam, Kuchinski Cohen.

Supervision: Levy, Shavit.

Conflict of Interest Disclosures: None reported.

Additional Contributions: In addition to the individuals recognized previously, we acknowledge the following individuals for their assistance with this study: Nachshon Buchshtav, MD (Pediatric Emergency Department, HaEmek Medical Center), for data collection; Giora Weiser, MD (Pediatric Emergency Department, Shaare Zedek Medical Center), for data collection and data assistance; Zeev Schnapp, MD (Pediatric Emergency Department, Carmel Medical Center), for data collection; and Irena Chistyakov, MD (Pediatric Emergency Department, Bnai Zion Medical Center), for data collection. None of these individuals received compensation for their roles in the study.

References
1.
Information for health care providers about multisystem inflammatory syndrome in children. Centers for Disease Control and Prevention. Accessed April 12, 2022. https://www.cdc.gov/mis/hcp/index.html
2.
Miller  AD , Zambrano  LD , Yousaf  AR ,  et al; MIS-C Surveillance Authorship Group.  Multisystem inflammatory syndrome in children—United States, February 2020-July 2021.   Clin Infect Dis. Published online December 5, 2021. doi:10.1093/cid/ciab1007PubMedGoogle ScholarCrossref
3.
SARS-CoV-2 variants in analyzed sequences, Israel. Our World in Data. Accessed April 12, 2022. https://ourworldindata.org/grapher/covid-variants-area?country=~ISR
4.
COVID-19 reservoir. Data Gov. Accessed May 12, 2022. https://data.gov.il/dataset/covid-19
5.
Cloete  J , Kruger  A , Masha  M ,  et al.  Paediatric hospitalisations due to COVID-19 during the first SARS-CoV-2 Omicron (B.1.1.529) variant wave in South Africa: a multicentre observational study.   Lancet Child Adolesc Health. 2022;6(5):294-302. doi:10.1016/S2352-4642(22)00027-XPubMedGoogle ScholarCrossref
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 credit toward the CME [and Self-Assessment requirements] of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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