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Zambrano, Laura D; Wu, Michael J; Martin, Lora; Malloch, Lacy; Chen, Sabrina; Newhams, Margaret M; Kucukak, Suden; Son, Mary Beth; Sanders, Cameron; Patterson, Kayla; Halasa, Natasha; Fitzgerald, Julie C; Leroue, Matthew K; Hall, Mark; Irby, Katherine; Rowan, Courtney M; Wellnitz, Kari; Sahni, Leila C; Loftis, Laura; Bradford, Tamara T; Staat, Mary; Babbitt, Christopher; Carroll, Christopher L; Pannaraj, Pia S; Kong, Michele; Schuster, Jennifer E; Chou, Janet; Patel, Manish M; Randolph, Adrienne G; Campbell, Angela P; Hobbs, Charlotte V
The Pediatric infectious disease journal, 06/2023, Volume: 42, Issue: 6Journal Article
In a 2020 pilot case-control study using medical records, we reported that non-Hispanic Black children were more likely to develop multisystem inflammatory syndrome in children (MIS-C) after adjustment for sociodemographic factors and underlying medical conditions. Using structured interviews, we investigated patient, household, and community factors underlying MIS-C likelihood. MIS-C case patients hospitalized in 2021 across 14 US pediatric hospitals were matched by age and site to outpatient controls testing positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within 3 months of the admission date. Caregiver interviews queried race/ethnicity, medical history, and household and potential community exposures 1 month before MIS-C hospitalization (case-patients) or after SARS-CoV-2 infection (controls). We calculated adjusted odds ratios (aOR) using mixed-effects multivariable logistic regression. Among 275 case patients and 496 controls, race/ethnicity, social vulnerability and patient or family history of autoimmune/rheumatologic disease were not associated with MIS-C. In previously healthy children, MIS-C was associated with a history of hospitalization for an infection aOR: 4.8; 95% confidence interval (CI): 2.1-11.0. Household crowding (aOR: 1.7; 95% CI: 1.2-2.6), large event attendance (aOR: 1.7; 95% CI: 1.3-2.1), school attendance with limited masking (aOR: 2.6; 95% CI: 1.1-6.6), public transit use (aOR: 1.8; 95% CI: 1.4-2.4) and co-resident testing positive for SARS-CoV-2 (aOR: 2.2; 95% CI: 1.3-3.7) were associated with increased MIS-C likelihood, with risk increasing with the number of these factors. From caregiver interviews, we clarify household and community exposures associated with MIS-C; however, we did not confirm prior associations between sociodemographic factors and MIS-C.
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