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IRIS
Background: Multisystem inflammatory syndrome in children (MIS-C) is a severe complication of SARS-CoV-2 infection. It remains unclear how MIS-C phenotypes vary across SARS-CoV-2 variants. We aimed to investigate clinical characteristics and outcomes of MIS-C across SARS-CoV-2 eras. Methods: We performed a multicentre observational retrospective study including seven paediatric hospitals in four countries (France, Spain, U.K., and U.S.). All consecutive confirmed patients with MIS-C hospitalised between February 1st, 2020, and May 31st, 2022, were included. Electronic Health Records (EHR) data were used to calculate pooled risk differences (RD) and effect sizes (ES) at site level, using Alpha as reference. Meta-analysis was used to pool data across sites. Findings: Of 598 patients with MIS-C (61% male, 39% female; mean age 9.7 years [SD 4.5]), 383 (64%) were admitted in the Alpha era, 111 (19%) in the Delta era, and 104 (17%) in the Omicron era. Compared with patients admitted in the Alpha era, those admitted in the Delta era were younger (ES -1.18 years [95% CI -2.05, -0.32]), had fewer respiratory symptoms (RD -0.15 [95% CI -0.33, -0.04]), less frequent non-cardiogenic shock or systemic inflammatory response syndrome (SIRS) (RD -0.35 [95% CI -0.64, -0.07]), lower lymphocyte count (ES -0.16 × 109/uL [95% CI -0.30, -0.01]), lower C-reactive protein (ES -28.5 mg/L [95% CI -46.3, -10.7]), and lower troponin (ES -0.14 ng/mL [95% CI -0.26, -0.03]). Patients admitted in the Omicron versus Alpha eras were younger (ES -1.6 years [95% CI -2.5, -0.8]), had less frequent SIRS (RD -0.18 [95% CI -0.30, -0.05]), lower lymphocyte count (ES -0.39 × 109/uL [95% CI -0.52, -0.25]), lower troponin (ES -0.16 ng/mL [95% CI -0.30, -0.01]) and less frequently received anticoagulation therapy (RD -0.19 [95% CI -0.37, -0.04]). Length of hospitalization was shorter in the Delta versus Alpha eras (-1.3 days [95% CI -2.3, -0.4]). Interpretation: Our study suggested that MIS-C clinical phenotypes varied across SARS-CoV-2 eras, with patients in Delta and Omicron eras being younger and less sick. EHR data can be effectively leveraged to identify rare complications of pandemic diseases and their variation over time. Funding: None.
Clinical phenotypes and outcomes in children with multisystem inflammatory syndrome across SARS-CoV-2 variant eras: a multinational study from the 4CE consortium
Sperotto, Francesca;Gutiérrez-Sacristán, Alba;Makwana, Simran;Li, Xiudi;Rofeberg, Valerie N.;Cai, Tianxi;Bourgeois, Florence T.;Omenn, Gilbert S.;Hanauer, David A.;Sáez, Carlos;Bonzel, Clara-Lea;Bucholz, Emily;Dionne, Audrey;Elias, Matthew D.;García-Barrio, Noelia;González, Tomás González;Issitt, Richard W.;Kernan, Kate F.;Laird-Gion, Jessica;Maidlow, Sarah E.;Mandl, Kenneth D.;Ahooyi, Taha Mohseni;Moraleda, Cinta;Morris, Michele;Moshal, Karyn L.;Pedrera-Jiménez, Miguel;Shah, Mohsin A.;South, Andrew M.;Spiridou, Anastasia;Taylor, Deanne M.;Verdy, Guillaume;Visweswaran, Shyam;Wang, Xuan;Xia, Zongqi;Zachariasse, Joany M.;Newburger, Jane W.;Avillach, Paul;Aaron, James R.;Adam, Atif;Agapito, Giuseppe;Albayrak, Adem;Albi, Giuseppe;Alessiani, Mario;Alloni, Anna;Amendola, Danilo F.;Angoulvant, François;Anthony, Li LLJ.;Aronow, Bruce J.;Ashraf, Fatima;Atz, Andrew;Avillach, Paul;Panickan, Vidul Ayakulangara;Azevedo, Paula S.;Badenes, Rafael;Balshi, James;Batugo, Ashley;Beaulieu-Jones, Brendin R.;Beaulieu-Jones, Brett K.;Bell, Douglas S.;Bellasi, Antonio;Bellazzi, Riccardo;Benoit, Vincent;Beraghi, Michele;Bernal-Sobrino, José Luis;Bernaux, Mélodie;Bey, Romain;Bhatnagar, Surbhi;Blanco-Martínez, Alvar;Boeker, Martin;Bonzel, Clara-Lea;Booth, John;Bosari, Silvano;Bourgeois, Florence T.;Bradford, Robert L.;Brat, Gabriel A.;Bréant, Stéphane;Brown, Nicholas W.;Bruno, Raffaele;Bryant, William A.;Bucalo, Mauro;Bucholz, Emily;Burgun, Anita;Cai, Tianxi;Cannataro, Mario;Carmona, Aldo;Cattelan, Anna Maria;Caucheteux, Charlotte;Champ, Julien;Chen, Jin;Chen, Krista Y.;Chiovato, Luca;Chiudinelli, Lorenzo;Cho, Kelly;Cimino, James J.;Colicchio, Tiago K.;Cormont, Sylvie;Cossin, Sébastien;Craig, Jean B.;Cruz-Bermúdez, Juan Luis;Cruz-Rojo, Jaime;Dagliati, Arianna;Daniar, Mohamad;Daniel, Christel;Das, Priyam;Devkota, Batsal;Dionne, Audrey;Duan, Rui;Dubiel, Julien;DuVall, Scott L.;Esteve, Loic;Estiri, Hossein;Fan, Shirley;Follett, Robert W.;Ganslandt, Thomas;García-Barrio, Noelia;Garmire, Lana X.;Gehlenborg, Nils;Getzen, Emily J.;Geva, Alon;Goh, Rachel SJ.;González, Tomás González;Gradinger, Tobias;Gramfort, Alexandre;Griffier, Romain;Griffon, Nicolas;Grisel, Olivier;Gutiérrez-Sacristán, Alba;Guzzi, Pietro H.;Han, Larry;Hanauer, David A.;Haverkamp, Christian;Hazard, Derek Y.;He, Bing;Henderson, Darren W.;Hilka, Martin;Ho, Yuk-Lam;Holmes, John H.;Honerlaw, Jacqueline P.;Hong, Chuan;Huling, Kenneth M.;Hutch, Meghan R.;Issitt, Richard W.;Jannot, Anne Sophie;Jouhet, Vianney;Kainth, Mundeep K.;Kate, Kernan F.;Kavuluru, Ramakanth;Keller, Mark S.;Kennedy, Chris J.;Kernan, Kate F.;Key, Daniel A.;Kirchoff, Katie;Klann, Jeffrey G.;Kohane, Isaac S.;Krantz, Ian D.;Kraska, Detlef;Krishnamurthy, Ashok K.;L'Yi, Sehi;Leblanc, Judith;Lemaitre, Guillaume;Lenert, Leslie;Leprovost, Damien;Liu, Molei;Will Loh, Ne Hooi;Long, Qi;Lozano-Zahonero, Sara;Luo, Yuan;Lynch, Kristine E.;Mahmood, Sadiqa;Maidlow, Sarah E.;Makoudjou, Adeline;Makwana, Simran;Malovini, Alberto;Mandl, Kenneth D.;Mao, Chengsheng;Maram, Anupama;Maripuri, Monika;Martel, Patricia;Martins, Marcelo R.;Marwaha, Jayson S.;Masino, Aaron J.;Mazzitelli, Maria;Mazzotti, Diego R.;Mensch, Arthur;Milano, Marianna;Minicucci, Marcos F.;Moal, Bertrand;Ahooyi, Taha Mohseni;Moore, Jason H.;Moraleda, Cinta;Morris, Jeffrey S.;Morris, Michele;Moshal, Karyn L.;Mousavi, Sajad;Mowery, Danielle L.;Murad, Douglas A.;Murphy, Shawn N.;Naughton, Thomas P.;Breda Neto, Carlos Tadeu;Neuraz, Antoine;Newburger, Jane;Ngiam, Kee Yuan;Njoroge, Wanjiku FM.;Norman, James B.;Obeid, Jihad;Okoshi, Marina P.;Olson, Karen L.;Omenn, Gilbert S.;Orlova, Nina;Ostasiewski, Brian D.;Palmer, Nathan P.;Paris, Nicolas;Patel, Lav P.;Pedrera-Jiménez, Miguel;Pfaff, Ashley C.;Pfaff, Emily R.;Pillion, Danielle;Pizzimenti, Sara;Priya, Tanu;Prokosch, Hans U.;Prudente, Robson A.;Prunotto, Andrea;Quirós-González, Víctor;Ramoni, Rachel B.;Raskin, Maryna;Rieg, Siegbert;Roig-Domínguez, Gustavo;Rojo, Pablo;Romero-Garcia, Nekane;Rubio-Mayo, Paula;Sacchi, Paolo;Sáez, Carlos;Salamanca, Elisa;Samayamuthu, Malarkodi Jebathilagam;Sanchez-Pinto, L. Nelson;Sandrin, Arnaud;Santhanam, Nandhini;Santos, Janaina C. C.;Sanz Vidorreta, Fernando J.;Savino, Maria;Schriver, Emily R.;Schubert, Petra;Schuettler, Juergen;Scudeller, Luigia;Sebire, Neil J.;Serrano-Balazote, Pablo;Serre, Patricia;Serret-Larmande, Arnaud;Shah, Mohsin A.;Hossein Abad, Zahra Shakeri;Silvio, Domenick;Sliz, Piotr;Son, Jiyeon;Sonday, Charles;South, Andrew M.;Sperotto, Francesca;Spiridou, Anastasia;Strasser, Zachary H.;Tan, Amelia LM.;Tan, Bryce W. Q.;Tan, Byorn W. L.;Tanni, Suzana E.;Taylor, Deanne M.;Terriza-Torres, Ana I.;Tibollo, Valentina;Tippmann, Patric;Toh, Emma MS.;Torti, Carlo;Trecarichi, Enrico M.;Vallejos, Andrew K.;Varoquaux, Gael;Vella, Margaret E.;Verdy, Guillaume;Vie, Jill-Jênn;Visweswaran, Shyam;Vitacca, Michele;Wagholikar, Kavishwar B.;Waitman, Lemuel R.;Wang, Xuan;Wassermann, Demian;Weber, Griffin M.;Wolkewitz, Martin;Wong, Scott;Xia, Zongqi;Xiong, Xin;Ye, Ye;Yehya, Nadir;Yuan, William;Zachariasse, Joany M.;Zahner, Janet J.;Zambelli, Alberto;Zhang, Harrison G.;Zöller, Daniela;Zuccaro, Valentina;Zucco, Chiara
2023-01-01
Abstract
Background: Multisystem inflammatory syndrome in children (MIS-C) is a severe complication of SARS-CoV-2 infection. It remains unclear how MIS-C phenotypes vary across SARS-CoV-2 variants. We aimed to investigate clinical characteristics and outcomes of MIS-C across SARS-CoV-2 eras. Methods: We performed a multicentre observational retrospective study including seven paediatric hospitals in four countries (France, Spain, U.K., and U.S.). All consecutive confirmed patients with MIS-C hospitalised between February 1st, 2020, and May 31st, 2022, were included. Electronic Health Records (EHR) data were used to calculate pooled risk differences (RD) and effect sizes (ES) at site level, using Alpha as reference. Meta-analysis was used to pool data across sites. Findings: Of 598 patients with MIS-C (61% male, 39% female; mean age 9.7 years [SD 4.5]), 383 (64%) were admitted in the Alpha era, 111 (19%) in the Delta era, and 104 (17%) in the Omicron era. Compared with patients admitted in the Alpha era, those admitted in the Delta era were younger (ES -1.18 years [95% CI -2.05, -0.32]), had fewer respiratory symptoms (RD -0.15 [95% CI -0.33, -0.04]), less frequent non-cardiogenic shock or systemic inflammatory response syndrome (SIRS) (RD -0.35 [95% CI -0.64, -0.07]), lower lymphocyte count (ES -0.16 × 109/uL [95% CI -0.30, -0.01]), lower C-reactive protein (ES -28.5 mg/L [95% CI -46.3, -10.7]), and lower troponin (ES -0.14 ng/mL [95% CI -0.26, -0.03]). Patients admitted in the Omicron versus Alpha eras were younger (ES -1.6 years [95% CI -2.5, -0.8]), had less frequent SIRS (RD -0.18 [95% CI -0.30, -0.05]), lower lymphocyte count (ES -0.39 × 109/uL [95% CI -0.52, -0.25]), lower troponin (ES -0.16 ng/mL [95% CI -0.30, -0.01]) and less frequently received anticoagulation therapy (RD -0.19 [95% CI -0.37, -0.04]). Length of hospitalization was shorter in the Delta versus Alpha eras (-1.3 days [95% CI -2.3, -0.4]). Interpretation: Our study suggested that MIS-C clinical phenotypes varied across SARS-CoV-2 eras, with patients in Delta and Omicron eras being younger and less sick. EHR data can be effectively leveraged to identify rare complications of pandemic diseases and their variation over time. Funding: None.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11571/1491978
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simulazione ASN
Il report seguente simula gli indicatori relativi alla propria produzione scientifica in relazione alle soglie ASN 2023-2025 del proprio SC/SSD. Si ricorda che il superamento dei valori soglia (almeno 2 su 3) è requisito necessario ma non sufficiente al conseguimento dell'abilitazione. La simulazione si basa sui dati IRIS e sugli indicatori bibliometrici alla data indicata e non tiene conto di eventuali periodi di congedo obbligatorio, che in sede di domanda ASN danno diritto a incrementi percentuali dei valori. La simulazione può differire dall'esito di un’eventuale domanda ASN sia per errori di catalogazione e/o dati mancanti in IRIS, sia per la variabilità dei dati bibliometrici nel tempo. Si consideri che Anvur calcola i valori degli indicatori all'ultima data utile per la presentazione delle domande.
La presente simulazione è stata realizzata sulla base delle specifiche raccolte sul tavolo ER del Focus Group IRIS coordinato dall’Università di Modena e Reggio Emilia e delle regole riportate nel DM 589/2018 e allegata Tabella A. Cineca, l’Università di Modena e Reggio Emilia e il Focus Group IRIS non si assumono alcuna responsabilità in merito all’uso che il diretto interessato o terzi faranno della simulazione. Si specifica inoltre che la simulazione contiene calcoli effettuati con dati e algoritmi di pubblico dominio e deve quindi essere considerata come un mero ausilio al calcolo svolgibile manualmente o con strumenti equivalenti.