Department of Pediatrics, Korea University Anam Hospital, Seoul, Korea.
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
J Korean Med Sci. 2023 Jul 31;38(30):e225. doi: 10.3346/jkms.2023.38.e225.
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.
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.
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.
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.
不同严重急性呼吸综合征冠状病毒 2 变异株患儿多系统炎症综合征 (MIS-C) 的发病率存在差异，但亚洲国家的流行病学情况知之甚少。我们调查并比较了韩国奥密克戎主导时期与前几个时期 MIS-C 的流行病学情况。
我们从韩国全国 MIS-C 监测中获得了 MIS-C 病例的临床、流行病学和实验室数据。我们将前德尔塔时期定义为 2020 年 1 月至 2021 年 5 月；德尔塔时期为 2021 年 6 月至 2021 年 12 月；奥密克戎时期为 2022 年 1 月至 2022 年 4 月。我们按时期描述 MIS-C 患者的临床特征和结局。
共评估了 91 例 MIS-C 病例。MIS-C 病例数从前德尔塔时期的 6 例增加到奥密克戎时期的 66 例，而发病率（每 100000 例报告的 2019 年冠状病毒病病例中的 MIS-C 病例数）已从前德尔塔时期的每 100000 例 38.5 例（95%置信区间 [CI]，14.1-83.9）降至奥密克戎时期的每 100000 例 1.6 例（95%CI，1.2-2.0）。在前德尔塔时期，分别有 66.7%和 100%的患者出现低血压和胃肠道受累；而在奥密克戎时期，分别有 12.1%和 6.1%的患者出现这种临床表现。前德尔塔时期 50%的 MIS-C 患者需要入住重症监护病房（ICU），而奥密克戎时期的 10.6%的患者需要入住 ICU。
与前德尔塔和德尔塔时期相比，奥密克戎时期的临床表现较轻。尽管奥密克戎时期的 MIS-C 发病率低于前德尔塔和德尔塔时期，但报告的 MIS-C 患者人数可能会带来很大的临床负担。
