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Risk and Phenotype of Multisystem Inflammatory Syndrome in Vaccinated and Unvaccinated Danish Children Before and During the Omicron Wave

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1 Credit CME

Multisystem inflammatory syndrome in children (MIS-C) is a severe manifestation of SARS-CoV-2 in children and adolescents.1 We aimed to estimate the risk of MIS-C after SARS-CoV-2 infection in vaccinated and unvaccinated individuals during the Omicron wave. Further, we aimed to compare the risk and clinical characteristics of MIS-C with the pre-Omicron waves.

This population-based cohort study prospectively included patients aged 0 to 17 years with MIS-C from all 18 Danish pediatric departments. Patients were diagnosed from January 1, 2022, to March 15, 2022, after SARS-CoV-2 infection between January 1 and February 1, 2022, when Omicron constituted more than 95% of variants. We followed the STROBE reporting guidelines for cohort studies. We used previously reported data to compare MIS-C during Omicron with the pre-Omicron waves.1,2

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Article Information

Accepted for Publication: May 4, 2022.

Published Online: June 8, 2022. doi:10.1001/jamapediatrics.2022.2206

Corresponding Author: Ulrikka Nygaard, MD, MPhil, PhD, Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark (ulrikka.nygaard@regionh.dk).

Author Contributions: Dr Nygaard and Ms Espenhain 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: Holm, Glenthoej, Schmidt, Brit Nordly, Hartling, Nygaard.

Acquisition, analysis, or interpretation of data: Holm, Espenhain, Glenthoej, Brit Nordly, Hartling, Nygaard.

Drafting of the manuscript: Holm, Espenhain, Glenthoej, Nygaard.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Holm, Espenhain, Nygaard.

Obtained funding: Nygaard.

Administrative, technical, or material support: Holm, Glenthoej, Schmidt, Nygaard.

Supervision: Brit Nordly, Hartling.

Conflict of Interest Disclosures: None reported.

Funding/Support: The study was supported by COVID-19 grant 0237-00004B from the National Ministry of Higher Education and Science and grant 0176-00020B from Innovation Fund Denmark.

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

References
1.
Nygaard  U , Holm  M , Hartling  UB ,  et al.  Incidence and clinical phenotype of multisystem inflammatory syndrome in children after infection with the SARS-CoV-2 delta variant by vaccination status: a Danish nationwide prospective cohort study.   Lancet Child Adolesc Health. Published online May 5, 2022. doi:10.1016/S2352-4642(22)00100-6PubMedGoogle ScholarCrossref
2.
Holm  M , Hartling  UB , Schmidt  LS ,  et al.  Multisystem inflammatory syndrome in children occurred in 1 of 4000 children with severe acute respiratory syndrome coronavirus 2.   Acta Paediatr. 2021;110(9):2581-2583. doi:10.1111/apa.15985PubMedGoogle ScholarCrossref
3.
Garcia-Beltran  WF , St Denis  KJ , Hoelzemer  A ,  et al.  mRNA-based COVID-19 vaccine boosters induce neutralizing immunity against SARS-CoV-2 Omicron variant.   Cell. 2022;185(3):457-466.e4. doi:10.1016/j.cell.2021.12.033PubMedGoogle ScholarCrossref
4.
Levy  M , Recher  M , Hubert  H ,  et al.  Multisystem inflammatory syndrome in children by COVID-19 vaccination status of adolescents in France.   JAMA. 2022;327(3):281-283. doi:10.1001/jama.2021.23262PubMedGoogle ScholarCrossref
5.
Zambrano  LD , Newhams  MM , Olson  SM ,  et al; Overcoming COVID-19 Investigators.  Effectiveness of BNT162b2 (Pfizer-BioNTech) mRNA vaccination against multisystem inflammatory syndrome in children among persons aged 12 to 18 years—US, July-December 2021.   MMWR Morb Mortal Wkly Rep. 2022;71(2):52-58. doi:10.15585/mmwr.mm7102e1PubMedGoogle ScholarCrossref
6.
Reese  H , Iuliano  AD , Patel  NN ,  et al.  Estimated incidence of coronavirus disease 2019 (COVID-19) illness and hospitalization—US, February-September 2020.   Clin Infect Dis. 2021;72(12):e1010-e1017. doi:10.1093/cid/ciaa1780PubMedGoogle ScholarCrossref
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