Study finds high rates of MIS-C in Latin American children
A Latin American study of children with COVID-19–related multisystem inflammatory syndrome (MIS-C) in The Pediatric Infectious Disease Journal found higher rates of the disease among Latin/Hispanic children compared with other global estimates.
The multicenter study evaluated 95 children (median age 7 years) diagnosed with MIS-C, a severe complication of COVID-19, from Jul 1 to Aug 11 in five Latin American countries—Mexico, Colombia, Peru, Costa Rica, and Brazil. Socioeconomic status was classified in a range from "very low status"—children from households earning less than each nation's minimum wage—to "high status" for children from families earning more than 16 times the minimum wage.
Of a total of 409 children infected with SARS-CoV-2, the virus that causes COVID-19, 23% fulfilled the criteria for MIS-C. The death rate for Latin American children with MIS-C was significantly higher than that reported in a European study (4.2% vs 0.68%), suggesting that SARS-CoV-2 may have a stronger impact on children in Latin America. Low socioeconomic status was significantly associated with greater need for pediatric intensive care unit (PICU) admission (P < 0.009) and mechanical ventilation (P < 0.04).
"The higher number of severe disease and deaths reported in our series, however, is not completely unexpected, since acute COVID-19 has been reported to disproportionately affect Hispanics and Blacks," the study authors wrote. They note that the study provides further evidence of the unequal impact of COVID-19 on vulnerable people, including children.
"Long-standing inequities in the social determinants of health, such as housing, economic instability, insurance status, and work circumstances of patients and their family members have systematically placed social, racial, and ethnic minority populations at higher risk for COVID-19 and more severe illness, and our data further support this view," the study authors concluded.
Jan 2021 Pediatr Infect Dis J study
COVID-19 causes more severe disease, death rate 3 times higher than flu
A French study yesterday in The Lancet Respiratory Medicine confirms that COVID-19 causes more severe disease than seasonal influenza, with a death rate three times higher than flu, after two studies earlier this week provided similar results.
Flu epidemics have been used as a model for the COVID-19 pandemic, but data are accumulating—including a recent US Veterans Administration Health System study—showing longer hospital stays, a higher risk of complications, and up to five times the risk of death for COVID-19.
Researchers compared 89,530 patients hospitalized with COVID-19 from Mar 1 to Apr 31 with 45,819 patients hospitalized with flu from Dec 1, 2018, to Feb 29, 2019. COVID-19 resulted in nearly twice as many hospital admissions as influenza at the peak of the 2018-19 flu season—the worst French flu season for deaths in the past 5 years.
The death rate for COVID-19 patients was almost three times higher than that for flu (16.9% vs 5.8%). More COVID-19 patients required intensive care unit (ICU) admission (16.3% vs 10.8%) and ICU stays were nearly twice as long as those for flu patients (15 days vs 8 days). COVID-19 patients were also more likely to require invasive mechanical ventilation (9.7% vs 4.0%) and experience acute respiratory failure (27.2% vs 17.4%).
"Taken together, our findings clearly indicate that COVID-19 is much more serious than seasonal influenza," said co-lead researcher Pascale Tubert-Bitter, PhD, in a Lancet news release.
The authors suggest that existing immunity to flu from previous exposure or vaccination could explain some of the observed differences, noting that very few people would be expected to have any immunity to the novel coronavirus that causes COVID-19.
"The large sample size is an important strength of the study and it is assumed that the indication for hospital admission in the two periods were the same and thus does not bias the results," Eskild Petersen, MD, wrote in a linked commentary. "The results clearly demonstrate that COVID-19 was more serious than seasonal influenza."
Dec 17 Lancet Respir Med study
Dec 17 Lancet Respir Med commentary
Dec 17 Lancet news release
Dec 16 CIDRAP news story on 2 recent similar studies