TY - JOUR
T1 - Severe Pediatric COVID-19 and Multisystem Inflammatory Syndrome in Children From Wild-type to Population Immunity
T2 - A Prospective Multicenter Cohort Study With Real-time Reporting
AU - Tulling, Adam J
AU - Lugthart, Gertjan
AU - Mooij, Miriam G
AU - Brackel, Caroline L H
AU - Terheggen-Lagro, Suzanne W J
AU - Oostenbrink, Rianne
AU - Buysse, Corinne M P
AU - Hashimoto, Simone
AU - Armbrust, Wineke
AU - Bannier, Michiel A G E
AU - Bekhof, Jolita
AU - van Gameren-Oosterom, Helma B
AU - Hendriks, Han
AU - van Houten, Marlies A
AU - van der Linden, Jan W
AU - Lebon, Ankie
AU - van Onzenoort-Bokken, Lonneke
AU - Tramper-Stranders, Gerdien A
AU - van Veen, Mirjam
AU - von Asmuth, Erik G J
AU - Buddingh, Emilie P
AU - COPP-study group
PY - 2023/12/1
Y1 - 2023/12/1
N2 - BACKGROUND: SARS-CoV-2 variant evolution and increasing immunity altered the impact of pediatric SARS-CoV-2 infection. Public health decision-making relies on accurate and timely reporting of clinical data. METHODS: This international hospital-based multicenter, prospective cohort study with real-time reporting was active from March 2020 to December 2022. We evaluated longitudinal incident rates and risk factors for disease severity. RESULTS: We included 564 hospitalized children with acute COVID-19 (n = 375) or multisystem inflammatory syndrome in children (n = 189) from the Netherlands, Curaçao and Surinam. In COVID-19, 134/375 patients (36%) needed supplemental oxygen therapy and 35 (9.3%) required intensive care treatment. Age above 12 years and preexisting pulmonary conditions were predictors for severe COVID-19. During omicron, hospitalized children had milder disease. During population immunity, the incidence rate of pediatric COVID-19 infection declined for older children but was stable for children below 1 year. The incidence rate of multisystem inflammatory syndrome in children was highest during the delta wave and has decreased rapidly since omicron emerged. Real-time reporting of our data impacted national pediatric SARS-CoV-2 vaccination- and booster-policies. CONCLUSIONS: Our data supports the notion that similar to adults, prior immunity protects against severe sequelae of SARS-CoV-2 infections in children. Real-time reporting of accurate and high-quality data is feasible and impacts clinical and public health decision-making. The reporting framework of our consortium is readily accessible for future SARS-CoV-2 waves and other emerging infections.
AB - BACKGROUND: SARS-CoV-2 variant evolution and increasing immunity altered the impact of pediatric SARS-CoV-2 infection. Public health decision-making relies on accurate and timely reporting of clinical data. METHODS: This international hospital-based multicenter, prospective cohort study with real-time reporting was active from March 2020 to December 2022. We evaluated longitudinal incident rates and risk factors for disease severity. RESULTS: We included 564 hospitalized children with acute COVID-19 (n = 375) or multisystem inflammatory syndrome in children (n = 189) from the Netherlands, Curaçao and Surinam. In COVID-19, 134/375 patients (36%) needed supplemental oxygen therapy and 35 (9.3%) required intensive care treatment. Age above 12 years and preexisting pulmonary conditions were predictors for severe COVID-19. During omicron, hospitalized children had milder disease. During population immunity, the incidence rate of pediatric COVID-19 infection declined for older children but was stable for children below 1 year. The incidence rate of multisystem inflammatory syndrome in children was highest during the delta wave and has decreased rapidly since omicron emerged. Real-time reporting of our data impacted national pediatric SARS-CoV-2 vaccination- and booster-policies. CONCLUSIONS: Our data supports the notion that similar to adults, prior immunity protects against severe sequelae of SARS-CoV-2 infections in children. Real-time reporting of accurate and high-quality data is feasible and impacts clinical and public health decision-making. The reporting framework of our consortium is readily accessible for future SARS-CoV-2 waves and other emerging infections.
U2 - 10.1097/INF.0000000000004098
DO - 10.1097/INF.0000000000004098
M3 - Article
SN - 0891-3668
VL - 42
SP - 1077
EP - 1085
JO - Pediatric Infectious Disease Journal
JF - Pediatric Infectious Disease Journal
IS - 12
ER -