Population‐based study of multisystem inflammatory syndrome associated with COVID‐19 found that 36% of children had persistent symptoms

Kahn, Robin; Berg, Stefan; Berntson, Lillemor; Berthold, Elisabet; Brodin, Petter; Bäckström, Fredrik; Compagno, Michele; Fasth, Anders; Horne, AnnaCarin; Hättting, Josefin; Król, Petra; Kukka, Antti Juhani; Mossberg, Maria; Månsson, Bengt; Nordenhäll, Charlotta; Nordström, Sam; Nyström, Fatine Khammari; Palmblad, Karin; Rasti, Reza; Rudolph, André; Rydenman, Karin; Sundberg, Erik; Säve-Söderbergh, Eva; Altman, Maria

doi:10.1111/apa.16191

Cited by 21 publications

(52 citation statements)

References 18 publications

(40 reference statements)

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“…Overall, the 21 studies included 81,896 children (range 14-71,700; median 58; IQR 25-151) 29-49 . The uncontrolled studies included 1,335 children with SARS-CoV-2 infection (range 14-518; median 50; IQR 19-106).…”

Section: Resultsmentioning

confidence: 99%

“…The controlled studies included 15,651 children with SARS-CoV-2 infection (range 16-11,950; median 280; IQR 72-2,411) and 64,910 children without SARS-CoV-2 infection (range 17-59,750; median 672; IQR 69-3,115). Nine studies had a sample size of more than 100 children (including controls) 30-34,40,42,46,49 . Children were analyzed as a subgroup in 4 studies 29,30,37,41 .…”

Section: Resultsmentioning

confidence: 99%

“…The other 3 controlled studies 30,33,34 had serious risk of bias because negative infection status was determined on the basis of having no documented COVID-19 diagnosis 30 or symptoms 33,34 regardless of laboratory virus detection. Risk of bias due to missing data was serious in 14 studies, because loss-to-follow-up was either>20% 29,31-34,37,39,40,42,43,48,49 or the information provided was unclear 35,38 . One study 41 reported following all participants but used multiple data sources without providing further details and was deemed to be of moderate risk of bias.…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-one studies were eligible (Table 1; Supplementary material: eFigure1). Six studies had a control group [29][30][31][32][33][34] and 15 were uncontrolled [35][36][37][38][39][40][41][42][43][44][45][46][47][48][49] . Twelve studies were conducted in Europe [29][30][31][32][33]36,[38][39][40]44,47,49 and 18 published in 2021 [29][30][31][32][33][35][36][37][39][40][41][42][43][44][45][46][47]…”

Section: Resultsmentioning

confidence: 99%

“…Seventeen studies recruited only hospitalized children [34][35][36]38,[41][42][43][44][45][46][47][48] , only children attending the hospital as outpatient 39 , or both 33,37,40,49 . Five of these 17 studies included children with multisystem inflammatory syndrome (MIS-C) 34,43,44,48,49 .…”

Section: Study Populationsmentioning

confidence: 99%

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Validity of reported post-acute health outcomes in children with SARS-CoV-2 infection: a systematic review

Hirt

Janiaud

Gloy

et al. 2022

Preprint

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Importance: There is concern that post-acute SARS-CoV-2 infection health outcomes ("post-COVID syndrome") in children could be a serious problem but at the same time there is concern about the validity of reported associations between infection and long-term outcomes. Objective: To systematically assess the validity of reported post-acute SARS-CoV-2 infection health outcomes in children. Evidence Review: A search on PubMed and Web of Science was conducted to identify studies published up to January 22, 2022, that reported on post-acute SARS-CoV-2 infection health outcomes in children (<18 years) with a minimum follow-up of 2 months since detection of infection or 1 month since recovery from acute illness. We assessed the consideration of confounding bias and causality, and the risk of bias. Findings: 21 studies including 81,896 children reported up to 97 symptoms with follow-up periods of 2-11.5 months. Fifteen studies had no control group. The reported proportion of children with post-COVID syndrome was between 0% and 66.5% in children with SARS-CoV-2 infection (n=16,986) and 2% to 53.3% in children without SARS-CoV-2 infection (n=64,910). Only 2 studies made a clear causal interpretation of an association of SARS-CoV-2 infection and the main outcome of "post-COVID syndrome" and provided recommendations regarding prevention measures. Two studies mentioned potential limitations in the conclusion of the main text but none of the 21 studies mentioned any limitations in the abstract nor made a clear statement for cautious interpretation. The validity of all 21 studies was seriously limited due to an overall critical risk of bias (critical risk for confounding bias [n=21]; serious or critical risk for selection bias [n=19]; serious risk for misclassification bias [n=3], for bias due to missing data [n=14] and for outcome measurement [n=12]; and critical risk for selective reporting bias [n=16]). Conclusions and Relevance: The validity of reported post-acute SARS-CoV-2 infection health outcomes in children is critically limited. None of the studies provided evidence with reasonable certainty on whether SARS-CoV-2 infection has an impact on post-acute health outcomes, let alone to what extent. Children and their families urgently need much more reliable and methodologically robust evidence to address their concerns and improve care.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Study Populationsmentioning

confidence: 99%

See 3 more Smart Citations

Validity of reported post-acute health outcomes in children with SARS-CoV-2 infection: a systematic review

Hirt

Janiaud

Gloy

et al. 2022

Preprint

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SARS-CoV-2 infections in children: Understanding diverse outcomes

Brodin

2022

Immunity

Self Cite

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SARS-CoV2 infections mostly lead to mild or even asymptomatic infections in children, but the reasons for this are not fully understood. More efficient local tissue responses, better thymic function, and cross-reactive immunity have all been proposed to explain this. In rare cases of children and young people, but very rarely in adults, post-infectious hyperinflammatory syndromes can develop and be serious. Here I will discuss our current understanding of SARS-CoV-2 infections in children and hypothesize that a life history and energy allocation perspective might offer an additional explanation to mild infections, viral dynamics and the higher incidence of rare multisystem inflammatory syndromes in children and young people.

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Risk factors for multisystem inflammatory syndrome in children – A population-based cohort study of over 2 million children

Rhedin

Lundholm²,

Horne³

et al. 2022

The Lancet Regional Health - Europe

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Population‐based study of multisystem inflammatory syndrome associated with COVID‐19 found that 36% of children had persistent symptoms

Abstract: This is an open access article under the terms of the Creat ive Commo ns Attri bution-NonCo mmercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Cited by 21 publications

References 18 publications

Validity of reported post-acute health outcomes in children with SARS-CoV-2 infection: a systematic review

Validity of reported post-acute health outcomes in children with SARS-CoV-2 infection: a systematic review

SARS-CoV-2 infections in children: Understanding diverse outcomes

Risk factors for multisystem inflammatory syndrome in children – A population-based cohort study of over 2 million children

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