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Sociodemographic Disparities in Severity of Multisystem Inflammatory Syndrome in Children: The National
Keila N Lopez1, Dongngan Truong2, Brett R Anderson3
1Division of Pediatric Cardiology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX.
Insights
Multisystem inflammatory syndrome in children (MIS-C) is more severe in Hispanic and Black children, and adolescents. These disparities highlight the need for targeted interventions to improve outcomes for vulnerable pediatric populations.
Area of Science:
- Pediatric critical care medicine
- Infectious diseases
- Health equity research
Background:
- Multisystem inflammatory syndrome in children (MIS-C) is a serious post-infectious complication of COVID-19.
- Understanding sociodemographic factors influencing MIS-C severity is crucial for equitable healthcare delivery.
Purpose of the Study:
- To investigate disparities in MIS-C severity and adverse outcomes based on sociodemographic factors.
- To identify risk factors associated with greater illness severity and prolonged hospital stays in pediatric MIS-C patients.
Main Methods:
- An observational study of 1115 children and adolescents (<21 years) diagnosed with MIS-C across 32 US pediatric centers.
- Key variables included patient distance to hospital, neighborhood social deprivation, race/ethnicity, and primary language.
- Outcomes assessed were composite illness severity, time to hospital admission, and hospital length of stay (LOS).
Main Results:
- Hispanic (OR 1.5) and non-Hispanic Black (OR 1.7) children experienced more severe illness.
- Adolescents aged 13-21 years had significantly higher odds of severe illness (OR 3.7) and longer LOS.
- Increased distance to hospital correlated with longer time from symptom onset to admission (P = .006).
Conclusions:
- Significant disparities in MIS-C severity and hospital outcomes exist, disproportionately affecting Hispanic, Black, and adolescent patients.
- These findings underscore the importance of addressing social determinants of health in pediatric infectious disease management.
- Continued research is vital to mitigate COVID-19-related disparities in pediatric care.
Objective:
To assess sociodemographic disparities associated with multisystem inflammatory syndrome (MIS-C) severity and adverse outcomes.
Study Design:
This long-term outcomes after the MUltisystem Inflammatory Syndrome In Children (MUSIC) observational study included persons <21 years old with MIS-C hospitalized at 1 of 32 large US pediatric MUSIC medical centers. The primary outcome was a composite greater illness severity (eg, inotropic medications, intubations), and secondary outcomes were days from symptom onset to hospital admission and hospital length of stay (LOS). Predictor variables included patient distance to the hospital, neighborhood Social Deprivation Index, race and ethnicity, and non-primary English language.
Results:
Among 1115 patients with MIS-C, median age was 9 years (IQR 5.6, 12.7), 39.2% were female, 28.1% were non-Hispanic Black, 27.8% were Hispanic, and 47.3% had public insurance. On multivariable analysis, more severe illness was seen among Hispanic patients (OR 1.5; 95% CI 1.1-2.2); non-Hispanic Black race (OR 1.7; 95% CI 1.2-2.4), and ages 13-21 years (OR 3.7; 95% CI 2.4-5.7). Longer time from symptom onset to hospital admission was associated with farther distance from hospital (P = .006). Risk factors for longer hospital LOS were adolescent age (≥13 years; P = .002), and non-Hispanic Black race (P = .018).
Conclusions:
Disparities in MIS-C severity outcomes and hospital LOS were associated with older age and being Black and/or Hispanic. Given the ongoing and newer strains of COVID-19, it is important to understand disease severity and disparities in outcomes due to MIS-C.
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