Active Surveillance With Seroprevalence-based Infection Rates Indicates Racial Disparities With Pediatric SARS-CoV-2...

Area of Science:

• Pediatric infectious diseases
• Epidemiology
• Health disparities

Background:

• Racial disparities in SARS-CoV-2 outcomes, including MIS-C and hospitalizations, are documented but based on incomplete data.
• Previous reports lacked population-based incidence, catchment populations, and infection prevalence, limiting understanding of disparities.
• This study addresses these limitations by using active surveillance and seroprevalence data.

Purpose of the Study:

• To characterize population-based incidence of MIS-C and COVID-19 hospitalizations in Black and White children.
• To compare incidence rates stratified by race using active surveillance and seroprevalence data.
• To investigate racial disparities in pediatric SARS-CoV-2 manifestations in Mississippi.

Main Methods:

• Active, population-based surveillance for MIS-C and COVID-19 hospitalizations was conducted from March 2020 to February 2021.
• Adjudicating clinicians at the University of Mississippi Medical Center identified cases meeting clinical and laboratory criteria.
• Race-stratified SARS-CoV-2 seroprevalence in children was estimated to calculate cumulative SARS-CoV-2 infections.

Main Results:

• Thirty-eight MIS-C cases and 74 pediatric COVID-19 hospitalizations were identified.
• Cumulative MIS-C incidence was 4.7 times higher in Black children (40.7 per 100,000 infections) versus White children (8.3 per 100,000 infections).
• COVID-19 hospitalization incidence was 62.3 per 100,000 infections in Black children and 33.1 per 100,000 infections in White children.

Conclusions:

• Strikingly higher incidence of SARS-CoV-2 hospitalization and MIS-C was observed in non-Hispanic Black children compared to White children.
• Disparities in SARS-CoV-2 manifestations were not explained by differences in exposure or testing.
• Targeted vaccine interventions are crucial to reduce observed disparities in pediatric SARS-CoV-2 outcomes.