Paediatric inflammatory multisystem syndrome in Canada: population-based surveillance and role of SARS-CoV-2 linkage

• Published in: Pediatric research 2023-11, Vol.94 (5), p.1744-1753
• Main Authors: 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.
• Format: Article
• Language: English
• Subjects: Canada - epidemiology; Child; Child, Preschool; Clinical; Clinical Research Article; COVID-19 - epidemiology; COVID-19 - therapy; Female; Hospitalization; Humans; Intensive care; Male; Medicine; Medicine & Public Health; Pediatric Surgery; Pediatrics; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Surveillance; Systemic Inflammatory Response Syndrome - diagnosis; Systemic Inflammatory Response Syndrome - epidemiology
• ISSN: 0031-3998; 1530-0447
• DOI: 10.1038/s41390-023-02668-1

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