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Severe Pediatric COVID-19 and Multisystem Inflammatory Syndrome in Children From Wild-type to Population Immunity: A

Adam J Tulling1, Gertjan Lugthart1, Miriam G Mooij2

  • 1From the Department of Pediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, the Netherlands.

The Pediatric Infectious Disease Journal
|October 12, 2023
PubMed

Insights

Prior immunity protects children from severe COVID-19, similar to adults. Real-time data reporting influenced pediatric vaccination policies and is adaptable for future infectious disease outbreaks.

Area of Science:

  • Pediatric infectious diseases
  • Epidemiology
  • Public Health

Background:

  • SARS-CoV-2 variant evolution and increasing population immunity have changed the impact of COVID-19 in children.
  • Accurate and timely clinical data reporting is crucial for informed public health decisions.

Purpose of the Study:

  • To evaluate longitudinal incidence rates and risk factors for severe disease in hospitalized children with acute COVID-19 or multisystem inflammatory syndrome in children (MIS-C).
  • To assess the impact of real-time data reporting on public health policies.

Main Methods:

  • An international, hospital-based, multicenter prospective cohort study.
  • Real-time data collection from March 2020 to December 2022.
  • Inclusion of 564 hospitalized children with acute COVID-19 or MIS-C.

Main Results:

  • Among 375 children with acute COVID-19, 36% required supplemental oxygen and 9.3% needed intensive care. Predictors for severe COVID-19 included age over 12 and pre-existing pulmonary conditions.
  • Hospitalized children experienced milder disease during the Omicron wave.
  • The incidence of MIS-C peaked during the Delta wave and declined with Omicron's emergence. Pediatric COVID-19 incidence decreased in older children but remained stable in infants.
  • Real-time data reporting informed national pediatric SARS-CoV-2 vaccination and booster policies.

Conclusions:

  • Prior immunity, similar to adults, confers protection against severe SARS-CoV-2 sequelae in children.
  • Real-time, high-quality data reporting is feasible and significantly impacts clinical and public health decision-making.
  • The established reporting framework can be utilized for future SARS-CoV-2 waves and other emerging infectious diseases.
Abstract

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