Clinical phenotypes and outcomes in children with multisystem inflammatory syndrome across SARS-CoV-2 variant eras: a multinational study from the 4CE consortium

Isolated Depo-Medrol Administration under Tenon’s Capsule for Post-COVID-19 Uveitis in a Child: A Case Report and Literature Review

“…To date, variants of the virus that cause ocular symptoms have been described in the literature, but the severity of clinical presentations between specific viral variants in children remains poorly understood. To date, most analyses of the clinical complications of SARS-CoV-2 variants have been conducted on adults or without a direct link between a specific viral variant and a patient’s clinical phenotype [ 4 ]. A study described in 2022 in the US showed a high affinity of the Beta variant for receptors found on the surface of the eye, and an Omicron strain that more often manifests as ocular pruritus than conjunctival congestion [ 5 ].…”

“…Children may be at risk of severe infection, and a Kawasaki-like disease associated with the clinical manifestations of SARS-CoV-2 has been described in the literature, referred to as the new multisystem inflammatory syndrome in children (MIS-C) [ 6 ]. There are reports that during the period of the Delta and Omicron virus infections, patients with MIS-C were younger compared to those when the Alpha variant predominated, which may be related to differences in the pathogenicity of the variants [ 4 ]. The virus is transmitted by the droplet route [ 7 ], but the genetic material of the virus is also detectable within the eye in tears and conjunctival secretions [ 7 , 8 , 9 , 10 ].…”

COVID-19 waves in an urban setting 2020–2022: an electronic medical record analysis

“…Throughout the pandemic, several studies have compared outcomes between early or late phases or between variant waves, but few studies have examined outcomes longitudinally across waves of SARS-Cov-2 variants. Four large studies have reported differences in inpatient outcomes ( 3 ), perinatal outcomes ( 4 ), ECMO-related outcomes ( 5 ), and outcomes in children diagnosed with multisystem inflammatory syndrome (MIS-C) ( 6 ) across multiple SARS-CoV-2 waves. A review by Lin et al ( 7 ) found wild-type SARS-CoV-2 infection has less severe outcomes (e.g., intensive care unit [ICU] admission, hospitalization, and death) compared to other variants including Alpha, Delta, Gamma, and Beta.…”

Phenotypic Classification of Multisystem Inflammatory Syndrome in Children: A Latent Class Analysis

“…The landscape of MIS-C incidence, surveillance, and treatment has changed considerably since SARS-CoV-2 first emerged, highlighting the need for an updated categorization of MIS-C phenotypic clusters. Overall incidence of MIS-C has decreased as new SARS-CoV-2 variants such as Omicron and its descendants have emerged [17][18][19][20][21][22], but increases in MIS-C cases can still occur following surges in COVID-19 transmission [23,24]. Here, we apply statistical clustering methods on the largest cohort of U.S. MIS-C cases to date to systematically characterize MIS-C phenotypic clusters and investigate their association with clinical severity.…”