Jonathan M. Cohen (United Kingdom)

Evelina London Children's Hospital Paediatric Immunology & Infectious Diseases

Author Of 1 Presentation

LOWER RISK OF MULTISYSTEM INFLAMMATORY SYNDROME IN CHILDREN (MIC-S) WITH THE DELTA VARIANT OF SARS-COV-2

Date
Wed, 11.05.2022
Session Time
10:00 - 11:02
Session Type
Oral Presentations Session
Room
BANQUETING HALL
Lecture Time
10:22 - 10:32

Abstract

Backgrounds:

Multisystem Inflammatory Syndrome in Children (MIS-C, also known as PIMS-TS) typically occurs 2-6 weeks after exposure to SARS-CoV-2. Early estimates suggested a risk of MIS-C of 1 in 3-4000 infected children. Whether this risk is sustained with new SARS-CoV-2 variants remains unknown.

Methods:

We utilised prospective data from the NHS South Thames Paediatric Network (STPN), which manages all cases of MIS-C amongst 1·5 million children in South-East England, to assess trends over time. We compared MIS-C cases with two independent SARS-CoV-2 infection datasets. We used publicly available UK Health Security Agency case numbers weighted to child population distributions according to area population estimates from the Office for National Statistics (ONS). To avoid bias due to evolving testing behaviour, we also compared MIS-C cases to community infection rates, obtained from the ONS COVID-19 Infection Survey, which randomly selects individuals for fortnightly PCR tests. All three datasets were normalised to the peak of the Alpha wave, and plotted against time. MIS-C cases were plotted 40 days prior to hospitalisation, corresponding to the best fit of rising SARS-CoV-2 infection and MIS-C cases during the Alpha wave.

Results:

Compared with the Alpha wave, we found fewer cases of MIS-C relative to SARS-CoV-2 infections during both initial and subsequent Delta waves. This relative reduction continued into the Omicron wave.

Conclusions/Learning Points:

Re-infection rates with the Alpha or Delta variants and vaccination rates were very low during the Delta wave. As a result, lower MIS-C rate relative to SARS-CoV-2 infections during the Delta wave is unlikely to be explained by population level immunity from prior infection or vaccination. It is most likely due to viral mutations in key antigenic epitopes responsible for triggering the hyperinflammatory response observed with MIS-C.

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Presenter Of 1 Presentation

LOWER RISK OF MULTISYSTEM INFLAMMATORY SYNDROME IN CHILDREN (MIC-S) WITH THE DELTA VARIANT OF SARS-COV-2

Date
Wed, 11.05.2022
Session Time
10:00 - 11:02
Session Type
Oral Presentations Session
Room
BANQUETING HALL
Lecture Time
10:22 - 10:32

Abstract

Backgrounds:

Multisystem Inflammatory Syndrome in Children (MIS-C, also known as PIMS-TS) typically occurs 2-6 weeks after exposure to SARS-CoV-2. Early estimates suggested a risk of MIS-C of 1 in 3-4000 infected children. Whether this risk is sustained with new SARS-CoV-2 variants remains unknown.

Methods:

We utilised prospective data from the NHS South Thames Paediatric Network (STPN), which manages all cases of MIS-C amongst 1·5 million children in South-East England, to assess trends over time. We compared MIS-C cases with two independent SARS-CoV-2 infection datasets. We used publicly available UK Health Security Agency case numbers weighted to child population distributions according to area population estimates from the Office for National Statistics (ONS). To avoid bias due to evolving testing behaviour, we also compared MIS-C cases to community infection rates, obtained from the ONS COVID-19 Infection Survey, which randomly selects individuals for fortnightly PCR tests. All three datasets were normalised to the peak of the Alpha wave, and plotted against time. MIS-C cases were plotted 40 days prior to hospitalisation, corresponding to the best fit of rising SARS-CoV-2 infection and MIS-C cases during the Alpha wave.

Results:

Compared with the Alpha wave, we found fewer cases of MIS-C relative to SARS-CoV-2 infections during both initial and subsequent Delta waves. This relative reduction continued into the Omicron wave.

Conclusions/Learning Points:

Re-infection rates with the Alpha or Delta variants and vaccination rates were very low during the Delta wave. As a result, lower MIS-C rate relative to SARS-CoV-2 infections during the Delta wave is unlikely to be explained by population level immunity from prior infection or vaccination. It is most likely due to viral mutations in key antigenic epitopes responsible for triggering the hyperinflammatory response observed with MIS-C.

Hide