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Paediatric inflammatory multisystem syndrome in Canada: population-based surveillance and role of SARS-CoV-2 linkage
BACKGROUND: Paediatric inflammatory multisystem syndrome (PIMS) is a rare condition temporally associated with SARS-CoV-2 infection. Using national surveillance data, we compare presenting features and outcomes among children hospitalized with PIMS by SARS-CoV-2 linkage, and identify risk factors fo...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group US
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10241135/ https://www.ncbi.nlm.nih.gov/pubmed/37277605 http://dx.doi.org/10.1038/s41390-023-02668-1 |
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author | El Tal, Tala Morin, Marie-Paule Morris, Shaun K. Farrar, Daniel S. Berard, Roberta A. Kakkar, Fatima Moore Hepburn, Charlotte Baerg, Krista Beaufils, Camille Bennett, Terri-Lyn Benseler, Susanne M. Beaudoin-Bussières, Guillaume Chan, Kevin Cyr, Claude Dahdah, Nagib Donner, Elizabeth J. Drouin, Olivier Edjoc, Rojiemiahd Eljaouhari, Maryem Embree, Joanne E. Farrell, Catherine Finzi, Andrés Forgie, Sarah Giroux, Ryan Kang, Kristopher T. King, Melanie Laffin Thibodeau, Melanie Lang, Bianca Laxer, Ronald M. Luu, Thuy Mai McCrindle, Brian W. Orkin, Julia Papenburg, Jesse Pound, Catherine M. Price, Victoria E. Proulx-Gauthier, Jean-Philippe Purewal, Rupeena Sadarangani, Manish Salvadori, Marina I. Thibeault, Roseline Top, Karina A. Viel-Thériault, Isabelle Haddad, Elie Scuccimarri, Rosie Yeung, Rae S. M. |
author_facet | El Tal, Tala Morin, Marie-Paule Morris, Shaun K. Farrar, Daniel S. Berard, Roberta A. Kakkar, Fatima Moore Hepburn, Charlotte Baerg, Krista Beaufils, Camille Bennett, Terri-Lyn Benseler, Susanne M. Beaudoin-Bussières, Guillaume Chan, Kevin Cyr, Claude Dahdah, Nagib Donner, Elizabeth J. Drouin, Olivier Edjoc, Rojiemiahd Eljaouhari, Maryem Embree, Joanne E. Farrell, Catherine Finzi, Andrés Forgie, Sarah Giroux, Ryan Kang, Kristopher T. King, Melanie Laffin Thibodeau, Melanie Lang, Bianca Laxer, Ronald M. Luu, Thuy Mai McCrindle, Brian W. Orkin, Julia Papenburg, Jesse Pound, Catherine M. Price, Victoria E. Proulx-Gauthier, Jean-Philippe Purewal, Rupeena Sadarangani, Manish Salvadori, Marina I. Thibeault, Roseline Top, Karina A. Viel-Thériault, Isabelle Haddad, Elie Scuccimarri, Rosie Yeung, Rae S. M. |
author_sort | El Tal, Tala |
collection | PubMed |
description | BACKGROUND: Paediatric inflammatory multisystem syndrome (PIMS) is a rare condition temporally associated with SARS-CoV-2 infection. Using national surveillance data, we compare presenting features and outcomes among children hospitalized with PIMS by SARS-CoV-2 linkage, and identify risk factors for intensive care (ICU). METHODS: Cases were reported to the Canadian Paediatric Surveillance Program by a network of >2800 pediatricians between March 2020 and May 2021. Patients with positive versus negative SARS-CoV-2 linkages were compared, with positive linkage defined as any positive molecular or serologic test or close contact with confirmed COVID-19. ICU risk factors were identified with multivariable modified Poisson regression. RESULTS: We identified 406 children hospitalized with PIMS, including 49.8% with positive SARS-CoV-2 linkages, 26.1% with negative linkages, and 24.1% with unknown linkages. The median age was 5.4 years (IQR 2.5–9.8), 60% were male, and 83% had no comorbidities. Compared to cases with negative linkages, children with positive linkages experienced more cardiac involvement (58.8% vs. 37.4%; p < 0.001), gastrointestinal symptoms (88.6% vs. 63.2%; p < 0.001), and shock (60.9% vs. 16.0%; p < 0.001). Children aged ≥6 years and those with positive linkages were more likely to require ICU. CONCLUSIONS: Although rare, 30% of PIMS hospitalizations required ICU or respiratory/hemodynamic support, particularly those with positive SARS-CoV-2 linkages. IMPACT: We describe 406 children hospitalized with paediatric inflammatory multisystem syndrome (PIMS) using nationwide surveillance data, the largest study of PIMS in Canada to date. Our surveillance case definition of PIMS did not require a history of SARS-CoV-2 exposure, and we therefore describe associations of SARS-CoV-2 linkages on clinical features and outcomes of children with PIMS. Children with positive SARS-CoV-2 linkages were older, had more gastrointestinal and cardiac involvement, and hyperinflammatory laboratory picture. Although PIMS is rare, one-third required admission to intensive care, with the greatest risk amongst those aged ≥6 years and those with a SARS-CoV-2 linkage. |
format | Online Article Text |
id | pubmed-10241135 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Nature Publishing Group US |
record_format | MEDLINE/PubMed |
spelling | pubmed-102411352023-06-06 Paediatric inflammatory multisystem syndrome in Canada: population-based surveillance and role of SARS-CoV-2 linkage El Tal, Tala Morin, Marie-Paule Morris, Shaun K. Farrar, Daniel S. Berard, Roberta A. Kakkar, Fatima Moore Hepburn, Charlotte Baerg, Krista Beaufils, Camille Bennett, Terri-Lyn Benseler, Susanne M. Beaudoin-Bussières, Guillaume Chan, Kevin Cyr, Claude Dahdah, Nagib Donner, Elizabeth J. Drouin, Olivier Edjoc, Rojiemiahd Eljaouhari, Maryem Embree, Joanne E. Farrell, Catherine Finzi, Andrés Forgie, Sarah Giroux, Ryan Kang, Kristopher T. King, Melanie Laffin Thibodeau, Melanie Lang, Bianca Laxer, Ronald M. Luu, Thuy Mai McCrindle, Brian W. Orkin, Julia Papenburg, Jesse Pound, Catherine M. Price, Victoria E. Proulx-Gauthier, Jean-Philippe Purewal, Rupeena Sadarangani, Manish Salvadori, Marina I. Thibeault, Roseline Top, Karina A. Viel-Thériault, Isabelle Haddad, Elie Scuccimarri, Rosie Yeung, Rae S. M. Pediatr Res Clinical Research Article BACKGROUND: Paediatric inflammatory multisystem syndrome (PIMS) is a rare condition temporally associated with SARS-CoV-2 infection. Using national surveillance data, we compare presenting features and outcomes among children hospitalized with PIMS by SARS-CoV-2 linkage, and identify risk factors for intensive care (ICU). METHODS: Cases were reported to the Canadian Paediatric Surveillance Program by a network of >2800 pediatricians between March 2020 and May 2021. Patients with positive versus negative SARS-CoV-2 linkages were compared, with positive linkage defined as any positive molecular or serologic test or close contact with confirmed COVID-19. ICU risk factors were identified with multivariable modified Poisson regression. RESULTS: We identified 406 children hospitalized with PIMS, including 49.8% with positive SARS-CoV-2 linkages, 26.1% with negative linkages, and 24.1% with unknown linkages. The median age was 5.4 years (IQR 2.5–9.8), 60% were male, and 83% had no comorbidities. Compared to cases with negative linkages, children with positive linkages experienced more cardiac involvement (58.8% vs. 37.4%; p < 0.001), gastrointestinal symptoms (88.6% vs. 63.2%; p < 0.001), and shock (60.9% vs. 16.0%; p < 0.001). Children aged ≥6 years and those with positive linkages were more likely to require ICU. CONCLUSIONS: Although rare, 30% of PIMS hospitalizations required ICU or respiratory/hemodynamic support, particularly those with positive SARS-CoV-2 linkages. IMPACT: We describe 406 children hospitalized with paediatric inflammatory multisystem syndrome (PIMS) using nationwide surveillance data, the largest study of PIMS in Canada to date. Our surveillance case definition of PIMS did not require a history of SARS-CoV-2 exposure, and we therefore describe associations of SARS-CoV-2 linkages on clinical features and outcomes of children with PIMS. Children with positive SARS-CoV-2 linkages were older, had more gastrointestinal and cardiac involvement, and hyperinflammatory laboratory picture. Although PIMS is rare, one-third required admission to intensive care, with the greatest risk amongst those aged ≥6 years and those with a SARS-CoV-2 linkage. Nature Publishing Group US 2023-06-05 /pmc/articles/PMC10241135/ /pubmed/37277605 http://dx.doi.org/10.1038/s41390-023-02668-1 Text en © The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. |
spellingShingle | Clinical Research Article El Tal, Tala Morin, Marie-Paule Morris, Shaun K. Farrar, Daniel S. Berard, Roberta A. Kakkar, Fatima Moore Hepburn, Charlotte Baerg, Krista Beaufils, Camille Bennett, Terri-Lyn Benseler, Susanne M. Beaudoin-Bussières, Guillaume Chan, Kevin Cyr, Claude Dahdah, Nagib Donner, Elizabeth J. Drouin, Olivier Edjoc, Rojiemiahd Eljaouhari, Maryem Embree, Joanne E. Farrell, Catherine Finzi, Andrés Forgie, Sarah Giroux, Ryan Kang, Kristopher T. King, Melanie Laffin Thibodeau, Melanie Lang, Bianca Laxer, Ronald M. Luu, Thuy Mai McCrindle, Brian W. Orkin, Julia Papenburg, Jesse Pound, Catherine M. Price, Victoria E. Proulx-Gauthier, Jean-Philippe Purewal, Rupeena Sadarangani, Manish Salvadori, Marina I. Thibeault, Roseline Top, Karina A. Viel-Thériault, Isabelle Haddad, Elie Scuccimarri, Rosie Yeung, Rae S. M. Paediatric inflammatory multisystem syndrome in Canada: population-based surveillance and role of SARS-CoV-2 linkage |
title | Paediatric inflammatory multisystem syndrome in Canada: population-based surveillance and role of SARS-CoV-2 linkage |
title_full | Paediatric inflammatory multisystem syndrome in Canada: population-based surveillance and role of SARS-CoV-2 linkage |
title_fullStr | Paediatric inflammatory multisystem syndrome in Canada: population-based surveillance and role of SARS-CoV-2 linkage |
title_full_unstemmed | Paediatric inflammatory multisystem syndrome in Canada: population-based surveillance and role of SARS-CoV-2 linkage |
title_short | Paediatric inflammatory multisystem syndrome in Canada: population-based surveillance and role of SARS-CoV-2 linkage |
title_sort | paediatric inflammatory multisystem syndrome in canada: population-based surveillance and role of sars-cov-2 linkage |
topic | Clinical Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10241135/ https://www.ncbi.nlm.nih.gov/pubmed/37277605 http://dx.doi.org/10.1038/s41390-023-02668-1 |
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