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Post-COVID-19 paediatric inflammatory multisystem syndrome: association of ethnicity, key worker and socioeconomic

Jonathan Broad1,2, Julia Forman3, James Brighouse4

  • 1Department of Paediatric Infectious Disease, Evelina London Children's Healthcare, London, UK jonathanb.broad@gmail.com.

Archives of Disease in Childhood
|March 17, 2021
PubMed

Insights

Children from ethnic minority groups and deprived areas had higher rates of Paediatric Inflammatory Multisystem Syndrome Temporally associated with SARS-CoV-2 (PIMS-TS). Black children experienced longer hospital stays and were more likely to require ventilation.

Area of Science:

  • Pediatric critical care medicine
  • Infectious disease epidemiology
  • Public health and disparities

Background:

  • COVID-19 disproportionately affected adults from ethnic minority groups and key worker families.
  • Paediatric Inflammatory Multisystem Syndrome Temporally associated with SARS-CoV-2 (PIMS-TS) is a serious condition linked to COVID-19 in children.
  • Understanding risk factors for PIMS-TS in vulnerable pediatric populations is crucial.

Purpose of the Study:

  • To investigate the association between ethnicity, socioeconomic status, and key worker status with the incidence and severity of PIMS-TS.
  • To compare PIMS-TS incidence in different ethnic and socioeconomic groups within the South Thames Retrieval Service (STRS) region.
  • To analyze the impact of these factors on hospital admission duration and need for critical care interventions.

Main Methods:

  • A population-based retrospective cohort study of 70 children diagnosed with PIMS-TS at Evelina London Children's Hospital (ELCH) between February and June 2020.
  • Incidence rates were calculated and compared between ethnic groups and socioeconomic strata using census data and the Index of Multiple Deprivation (IMD).
  • Regression analysis was employed to assess the association of ethnicity and IMD with admission length, intensive care, inotropes, and ventilation requirements.

Main Results:

  • Significantly higher PIMS-TS incidence was observed in children from Black (25.0/100,000), Asian (6.4/100,000), and other (17.8/100,000) ethnic groups compared to White children (1.6/100,000).
  • Incidence was also higher in more deprived areas (quintile 1: 8.1/100,000) compared to the least deprived (quintile 5: 1.6/100,000).
  • Children from Black ethnic groups had 38% longer hospital stays, and 90% of children requiring ventilation were from Black ethnic groups.

Conclusions:

  • Children from ethnic minority backgrounds, deprived areas, and key worker families are over-represented in PIMS-TS cases.
  • Ethnicity, particularly Black ethnicity, is associated with increased PIMS-TS severity, including longer admissions and a higher likelihood of requiring ventilation.
  • These findings highlight significant health disparities in pediatric COVID-19 related inflammatory syndromes, necessitating targeted public health interventions.
Abstract

Keywords:
adolescent healthcardiologyepidemiologystatisticsvirology

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