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Nationwide Survey of Multisystem Inflammatory Syndrome in Children Associated with Coronavirus Disease 2019 in Japan

Daisuke Matsubara1, Yuri Matsubara2, Mamoru Ayusawa3

  • 1Department of Pediatrics, Jichi Medical University, 3311-1 Shimotsuke, Tochigi, 329-0498, Japan. 99081dm@jichi.ac.jp.

Journal of Clinical Immunology
|November 29, 2024
PubMed

Insights

Multisystem inflammatory syndrome in children (MIS-C) is rare in Japan and often resembles Kawasaki disease (KD). Cases were less severe than anticipated, with fewer critical outcomes reported.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Epidemiology

Background:

  • Multisystem inflammatory syndrome in children (MIS-C) shares clinical similarities with Kawasaki disease (KD).
  • Understanding MIS-C's characteristics in Japan is crucial, given KD's prevalence.
  • This study addresses the unknown clinical features of MIS-C in the Japanese pediatric population.

Purpose of the Study:

  • To determine the epidemiological and clinical features of MIS-C in Japan.
  • To compare MIS-C presentation with Kawasaki disease phenotypes.
  • To assess the incidence and severity of MIS-C in relation to COVID-19 variants.

Main Methods:

  • A nationwide registry of MIS-C cases was established from November 2020 to March 2023.
  • Prospective and retrospective enrollment of patients meeting MIS-C criteria.
  • Data collected included incidence rates, clinical features, organ involvement, and outcomes like shock and coronary artery lesions.

Main Results:

  • 129 MIS-C cases were identified, with an incidence of 1.5 per 100,000 COVID-19 cases.
  • 80% of cases occurred during the Omicron variant period; 72% met KD criteria.
  • Cardiovascular and gastrointestinal involvement were common, but overall severity was lower than expected, with 11.6% developing coronary artery lesions and no fatalities.

Conclusions:

  • MIS-C incidence in Japan is low.
  • Japanese MIS-C cases exhibit a distinct KD-like phenotype with generally milder clinical features.
  • The findings provide valuable insights into MIS-C epidemiology and clinical presentation in Japan.
Abstract

Keywords:
COVID-19Kawasaki diseaseincidencemultisystem inflammatory syndrome in children

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