Multisystem inflammatory syndrome in children (MIS-C) seems to be more common and more severe than previously thought, according to a study published online Jan. 5 in JAMA Network Open.

William Encinosa, Ph.D., from the Agency for Healthcare Research and Quality in Rockville, Maryland, and colleagues compared outcomes for MIS-C and COVID-19 across 4,057 hospitals in 31 states in a retrospective study.

Overall, 4,107 individuals with MIS-C and 23,686 with COVID-19 without MIS-C were identified. The researchers found 1.48 MIS-C hospitalizations per 100,000 children per month, ranging from 0.97 to 1.99 hospitalizations per 100 children for White and Black children, respectively. As the number of organ system dysfunctions increased from two to eight organs, outcomes worsened: Deaths associated with MIS-C and with COVID-19 increased, from <1 to 5.8 percent and from <1 to 17.2 percent, respectively. An increase in adverse medication events associated with MIS-C and COVID-19 was also observed, from 4.9 to 17.8 percent and from 1.2 to 13.4 percent, respectively. As organ dysfunction increased, the percentage of MIS-C cases that were in Black children doubled from 16.2 to 31.7 percent, while remaining unchanged with COVID-19.

“The findings by Encinosa et al. increase our knowledge of MIS-C and COVID-19 disparities and outcomes, shedding light on the risks and impacts of increasing organ system dysfunction,” write the authors of an accompanying editorial.

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JAMA Network Open

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