Severe Pediatric COVID-19 and Multisystem Inflammatory Syndrome in Children From Wild-type to Population Immunity: A Prospective Multicenter Cohort Study With Real-time Reporting

COPP-study group, Adam J. Tulling, Gertjan Lugthart, Miriam G. Mooij, Caroline L.H. Brackel, Suzanne W.J. Terheggen-Lagro, Rianne Oostenbrink, Corinne M.P. Buysse, Simone Hashimoto, Wineke Armbrust, Michiel A.G.E. Bannier, Jolita Bekhof, Helma B. van Gameren-Oosterom, Han Hendriks, Marlies A. van Houten, Jan W. van der Linden, Ankie Lebon, Lonneke van Onzenoort-Bokken, Gerdien A. Tramper-Stranders, Mirjam van VeenErik G.J. von Asmuth, Emilie P. Buddingh*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Scopus)
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Abstract

BACKGROUND: SARS-CoV-2 variant evolution and increasing immunity altered the impact of pediatric SARS-CoV-2 infection. Public health decision-making relies on accurate and timely reporting of clinical data. METHODS: This international hospital-based multicenter, prospective cohort study with real-time reporting was active from March 2020 to December 2022. We evaluated longitudinal incident rates and risk factors for disease severity. RESULTS: We included 564 hospitalized children with acute COVID-19 (n = 375) or multisystem inflammatory syndrome in children (n = 189) from the Netherlands, Curaçao and Surinam. In COVID-19, 134/375 patients (36%) needed supplemental oxygen therapy and 35 (9.3%) required intensive care treatment. Age above 12 years and preexisting pulmonary conditions were predictors for severe COVID-19. During omicron, hospitalized children had milder disease. During population immunity, the incidence rate of pediatric COVID-19 infection declined for older children but was stable for children below 1 year. The incidence rate of multisystem inflammatory syndrome in children was highest during the delta wave and has decreased rapidly since omicron emerged. Real-time reporting of our data impacted national pediatric SARS-CoV-2 vaccination- and booster-policies. CONCLUSIONS: Our data supports the notion that similar to adults, prior immunity protects against severe sequelae of SARS-CoV-2 infections in children. Real-time reporting of accurate and high-quality data is feasible and impacts clinical and public health decision-making. The reporting framework of our consortium is readily accessible for future SARS-CoV-2 waves and other emerging infections.

Original languageEnglish
Pages (from-to)1077-1085
Number of pages9
JournalThe Pediatric infectious disease journal
Volume42
Issue number12
DOIs
Publication statusPublished - 1 Dec 2023

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© 2023 Lippincott Williams and Wilkins. All rights reserved.

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