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J Korean Med Sci . Change in Severity and Clinical Manifestation of MIS-C Over SARS-CoV-2 Variant Outbreaks in Korea

tetano

Editor, Senior Moderator
J Korean Med Sci


. 2023 Jul 31;38(30):e225.
doi: 10.3346/jkms.2023.38.e225. Change in Severity and Clinical Manifestation of MIS-C Over SARS-CoV-2 Variant Outbreaks in Korea

Young June Choe[SUP] 1 [/SUP], Eun Hwa Choi[SUP] 2 [/SUP], Jong Woon Choi[SUP] 3 [/SUP], Byung Wook Eun[SUP] 4 [/SUP], Lucy Youngmin Eun[SUP] 5 [/SUP], Yae-Jean Kim[SUP] 6 [/SUP], Yeo Hyang Kim[SUP] 7 [/SUP], Young A Kim[SUP] 8 [/SUP], Yun-Kyung Kim[SUP] 9 [/SUP], Ji Hee Kwak[SUP] 6 10 [/SUP], Hyukmin Lee[SUP] 11 [/SUP], June Dong Park[SUP] 12 [/SUP], Yeon Haw Jung[SUP] 11 [/SUP], Jin Gwack[SUP] 13 [/SUP], Sangwon Lee[SUP] 13 [/SUP]; MIS-C Surveillance Group



Affiliations
Abstract

Background: There is difference in the incidence of multi-system inflammatory syndrome in children (MIS-C) in patients with different variants of severe acute respiratory syndrome coronavirus 2, however, little is known about the epidemiology in Asian countries. We investigated and compared the epidemiology of the MIS-C during omicron-dominant period with that of previous periods in South Korea.
Methods: We obtained clinical, epidemiological and laboratory data on MIS-C cases from national MIS-C surveillance in South Korea. We defined pre-delta period as January 2020-May 2021; delta period as June 2021-December 2021; and omicron period as January 2022-April 2022. We describe the clinical characteristics and outcomes of MIS-C patients by period.
Results: A total of 91 cases were assessed to be MIS-C cases. Number of MIS-C cases have increased from six cases during pre-delta period to 66 cases during omicron period, while the incidence rate (the number of MIS-C cases per 100,000 cases of reported coronavirus disease 2019) has decreased from 38.5 cases per 100,000 (95% confidence interval [CI], 14.1-83.9) during pre-delta period to 1.6 cases per 100,000 (95% CI, 1.2-2.0) during omicron periods. During pre-delta period, 66.7% and 100% had hypotension and gastrointestinal involvement, respectively; while during omicron period, 12.1% and 6.1% had such clinical manifestations. Fifty percent of pre-delta MIS-C patients were taken intensive care unit (ICU) cares, while 10.6% of patients during omicron periods were in ICUs.
Conclusion: Omicron period were associated with less severe clinical manifestation compared to pre-delta and delta periods. Although incidence rate of MIS-C was lower for the omicron period than pre-delta and delta periods, number of patients reported with MIS-C may pose a substantial clinical burden.

Keywords: COVID-19; MIS-C; SARS-CoV-2.

 
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