Examining the Association Between MIS-C and the Child Opportunity Index at a Single Center

Abstract

OBJECTIVE To describe associations between the Child Opportunity Index (COI) and multisystem inflammatory syndrome of childhood (MIS-C) diagnosis among hospitalized children. METHODS We used a retrospective case control study design to examine children ≤21 years hospitalized at a single, tertiary care children’s hospital between March 2020 and June 2021. Our study population included children diagnosed with MIS-C (n = 111) and a control group of children hospitalized for MIS-C evaluation who had an alternative diagnosis (n = 61). Census tract COI was the exposure variable, determined using the patient’s home address mapped to the census tract. Our outcome measure was MIS-C diagnosis. Odds ratios measured associations between COI and MIS-C diagnosis. RESULTS Our study population included 111 children diagnosed with MIS-C and 61 children evaluated but ruled out for MIS-C. The distribution of census tract overall COI differed significantly between children diagnosed with MIS-C compared with children with an alternate diagnosis (P = .03). Children residing in census tracts with very low to low overall COI (2.82, 95% confidence interval [CI]: 1.29–6.17) and very low to low health/environment COI (4.69, 95% CI 2.21–9.97) had significantly higher odds of being diagnosed with MIS-C compared with children living in moderate and high to very high COI census tracts, respectively. CONCLUSION Census tract child opportunity is associated with MIS-C diagnosis among hospitalized children suggesting an important contribution of place-based determinants in the development of MIS-C.

Elevated risk for psychiatric outcomes in pediatric patients with Multisystem Inflammatory Syndrome (MIS-C): A review of neuroinflammatory and psychosocial stressors

“…MIS-C children may also be at risk of experiencing greater levels of environmental stressors due to socioeconomic disparities in MIS-C risk and prevalence ( Dennis-Heyward, 2021 ). In a recent study that studied the association between MIS-C and Child Opportunity Index (COI: a measure of the environmental resources important for healthy childhood development) ( Acevedo-Garcia et al, 2020 ), children who scored lower in overall COI had significantly higher odds of being diagnosed with MIS-C compared with children who scored higher ( Tyris et al, 2022 ). Therefore, this indicates that a substantial number of MIS-C patients may also live in neighborhoods with lower health, educational, and nutritional resources, which are markers of childhood adversity that may further increase stress and psychiatric risk ( Jackson and Beaver, 2015 ; Lowe et al, 2016 ).…”

Emerging Insights Into the Pathophysiology of Multisystem Inflammatory Syndrome Associated With COVID-19 in Children

“… 23 , 26 , 27 , 28 , 31 , 32 While race/ethnicity-related differences regarding geographic factors and social determinants of health influencing risk of SARS-CoV-2 exposure may be at play, 33 , 34 Black and Hispanic children have a higher incidence of MIS-C per SARS-CoV-2 infection even after adjustments for socioeconomic status. 32 , 35 , 36 Further epidemiologic and mechanistic studies are needed to elucidate the nature of these associations.…”

Short- and mid-term outcomes of multisystem inflammatory syndrome in children: a longitudinal prospective single-center cohort study

“…MIS-c develops 2-6 weeks after exposure to SARS-CoV-2 and is believed to be a post-infectious autoimmune condition characterized by hyperinflammation and multi-organ damage (1). The risk factors for MIS-c include young school age (6-11 years), male sex, chronic comorbidities, obesity, and ethnicity (Hispanic or non-Hispanic black children) (2)(3)(4).…”