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Lower Risk of Multisystem Inflammatory Syndrome in Children With the Delta and Omicron Variants of Severe Acute

Jonathan M Cohen1,2, Michael J Carter3,4, C Ronny Cheung5,6

  • 1Paediatric Immunology and Infectious Diseases, Evelina London Children's Hospital, London, United Kingdom.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|July 5, 2022
PubMed

Insights

The risk of multisystem inflammatory syndrome in children (MIS-C) significantly decreased with different severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants. Omicron and Delta variants showed substantially lower MIS-C rates compared to earlier strains.

Area of Science:

  • Pediatric infectious diseases
  • Viral immunology
  • Public health epidemiology

Background:

  • Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious condition associated with SARS-CoV-2 infection.
  • Understanding the impact of different SARS-CoV-2 variants on MIS-C risk is crucial for public health strategies.

Purpose of the Study:

  • To investigate the association between distinct SARS-CoV-2 variants and the incidence of MIS-C in children.
  • To quantify the changes in MIS-C risk across different variant waves, including Delta and Omicron.

Main Methods:

  • Retrospective analysis of pediatric cases in southeast England.
  • Comparison of MIS-C incidence rates stratified by SARS-CoV-2 variant prevalence periods (pre-vaccine Delta, post-vaccine Delta, Omicron).
  • Calculation of rate ratios (RR) with 95% confidence intervals (CI) to assess risk changes.

Main Results:

  • MIS-C rates were substantially lower during the Delta variant periods (56% lower pre-vaccine, 66% lower post-vaccine) compared to earlier strains.
  • A dramatic 95% reduction in MIS-C rates was observed during the Omicron variant period.
  • All assessed SARS-CoV-2 variants, particularly Omicron, demonstrated a significantly decreased risk for MIS-C in children.

Conclusions:

  • The emergence of SARS-CoV-2 Delta and Omicron variants is associated with a significantly reduced risk of MIS-C in children.
  • These findings suggest a potential shift in the pathogenicity or host response related to newer variants.
  • Further research is warranted to elucidate the mechanisms behind the decreased MIS-C risk with evolving SARS-CoV-2 variants.

Keywords:
COVID-19MIS-CPIMS-TSSARS-CoV-2coronavirus

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