Severe Pediatric COVID-19 and Multisystem Inflammatory Syndrome in Children from Wild-type to Population Immunity: A Prospective Multicenter Cohort Study with Real-time Reporting

Adam J. Tulling; Gertjan Lugthart; Miriam G. Mooij; Caroline L.H. Brackel; Suzanne W.J. Terheggen-Lagro; Rianne Oostenbrink; Corinne M.P. Buysse; Simone Hashimoto; Wineke Armbrust; Michiel A.G.E. Bannier; Jolita Bekhof; Helma B. Van Gameren-Oosterom; Han Hendriks; Marlies A. Van Houten; Jan W. Van Der Linden; Ankie Lebon; Lonneke Van Onzenoort-Bokken; Gerdien A. Tramper-Stranders; Mirjam Van Veen; Erik G.J. Von Asmuth; Emilie P. Buddingh; Leontien B. Van Der Aa; Koen J. Van Aerde; Bettina Auffarth-Smedema; Ingeborg Y. Bart; Cherise Beek; Gitanjali I. Bechan; J. Merlijn Van Den Berg; Venje H. Boonstra; Mijke Breukels; Danielle M.C. Brinkman; Patricia C.J.L. Bruijning-Verhagen; Stephanie C. De Crom; Margot R. Ernst-Kruis; Pieter L.A. Fraaij; Joyce Goris; Michael Groeneweg; Mariken Gruppen; Sanne C. Hammer; Petra C.E. Hissink Muller; Jenneke Homan-Van Der Veen; Monique A.M. Jacobs; Arvid W.A. Kamps; Naomi Ketharanathan; Martijn Van Der Kuip; Taco W. Kuijpers; Elizabeth G. Legger; Shirley Lo-A-Njoe; Meindert E. Manshande; Carien J. Miedema; Charlie C. Obihara; Gideon O. Olivieira; Annemarie Oudshoorn; Esther J.E. Peeters; Ronald Petru; Marielle W.H. Pijnenburg; Denise Rook; Kim Schilleman; Rian Schopmeijer; David Slotboom; Manouk Van Der Steen; Kim Stol; Yolande E.M. Thomasse; Wim J.E. Tissing; Xandra W. Van Den Tweel; Sebastiaan J. Vastert; Anne B. Verbeek; Annette M.M. Vernooij-Van Langen; Jantien W. Wieringa; Joanne G. Wildenbeest; Saskia N. De Wildt; Christiaan Van Woerden

doi:10.1097/INF.0000000000004098

Severe Pediatric COVID-19 and Multisystem Inflammatory Syndrome in Children from Wild-type to Population Immunity: A Prospective Multicenter Cohort Study with Real-time Reporting

Adam J. Tulling, Gertjan Lugthart, Miriam G. Mooij, Caroline L.H. Brackel, Suzanne W.J. Terheggen-Lagro, Rianne Oostenbrink, Corinne M.P. Buysse, Simone Hashimoto, Wineke Armbrust, Michiel A.G.E. Bannier, Jolita Bekhof, Helma B. Van Gameren-Oosterom, Han Hendriks, Marlies A. Van Houten, Jan W. Van Der Linden, Ankie Lebon, Lonneke Van Onzenoort-Bokken, Gerdien A. Tramper-Stranders, Mirjam Van Veen, Erik G.J. Von AsmuthEmilie P. Buddingh^*, Leontien B. Van Der Aa, Koen J. Van Aerde, Bettina Auffarth-Smedema, Ingeborg Y. Bart, Cherise Beek, Gitanjali I. Bechan, J. Merlijn Van Den Berg, Venje H. Boonstra, Mijke Breukels, Danielle M.C. Brinkman, Patricia C.J.L. Bruijning-Verhagen, Stephanie C. De Crom, Margot R. Ernst-Kruis, Pieter L.A. Fraaij, Joyce Goris, Michael Groeneweg, Mariken Gruppen, Sanne C. Hammer, Petra C.E. Hissink Muller, Jenneke Homan-Van Der Veen, Monique A.M. Jacobs, Arvid W.A. Kamps, Naomi Ketharanathan, Martijn Van Der Kuip, Taco W. Kuijpers, Elizabeth G. Legger, Shirley Lo-A-Njoe, Meindert E. Manshande, Carien J. Miedema, Charlie C. Obihara, Gideon O. Olivieira, Annemarie Oudshoorn, Esther J.E. Peeters, Ronald Petru, Marielle W.H. Pijnenburg, Denise Rook, Kim Schilleman, Rian Schopmeijer, David Slotboom, Manouk Van Der Steen, Kim Stol, Yolande E.M. Thomasse, Wim J.E. Tissing, Xandra W. Van Den Tweel, Sebastiaan J. Vastert, Anne B. Verbeek, Annette M.M. Vernooij-Van Langen, Jantien W. Wieringa, Joanne G. Wildenbeest, Saskia N. De Wildt, Christiaan Van Woerden

^*Corresponding author for this work

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Abstract

Background: SARS-CoV-2 variant evolution and increasing immunity altered the impact of pediatric SARS-CoV-2 infection. Public health decision-making relies on accurate and timely reporting of clinical data.

Methods: This international hospital-based multicenter, prospective cohort study with real-time reporting was active from March 2020 to December 2022. We evaluated longitudinal incident rates and risk factors for disease severity.

Results: We included 564 hospitalized children with acute COVID-19 (n = 375) or multisystem inflammatory syndrome in children (n = 189) from the Netherlands, Curaçao and Surinam. In COVID-19, 134/375 patients (36%) needed supplemental oxygen therapy and 35 (9.3%) required intensive care treatment. Age above 12 years and preexisting pulmonary conditions were predictors for severe COVID-19. During omicron, hospitalized children had milder disease. During population immunity, the incidence rate of pediatric COVID-19 infection declined for older children but was stable for children below 1 year. The incidence rate of multisystem inflammatory syndrome in children was highest during the delta wave and has decreased rapidly since omicron emerged. Real-time reporting of our data impacted national pediatric SARS-CoV-2 vaccination- and booster-policies.

Conclusions: Our data supports the notion that similar to adults, prior immunity protects against severe sequelae of SARS-CoV-2 infections in children. Real-time reporting of accurate and high-quality data is feasible and impacts clinical and public health decision-making. The reporting framework of our consortium is readily accessible for future SARS-CoV-2 waves and other emerging infections.

Original language	English
Pages (from-to)	1077-1085
Number of pages	9
Journal	Pediatric infectious disease journal
Volume	42
Issue number	12
DOIs	https://doi.org/10.1097/INF.0000000000004098
Publication status	Published - Dec-2023

Keywords

COVID-19
MIS-C
pediatrics
real-time reporting
SARS-CoV-2

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Tulling, A. J., Lugthart, G., Mooij, M. G., Brackel, C. L. H., Terheggen-Lagro, S. W. J., Oostenbrink, R., Buysse, C. M. P., Hashimoto, S., Armbrust, W., Bannier, M. A. G. E., Bekhof, J., Van Gameren-Oosterom, H. B., Hendriks, H., Van Houten, M. A., Van Der Linden, J. W., Lebon, A., Van Onzenoort-Bokken, L., Tramper-Stranders, G. A., Van Veen, M., ... Van Woerden, C. (2023). Severe Pediatric COVID-19 and Multisystem Inflammatory Syndrome in Children from Wild-type to Population Immunity: A Prospective Multicenter Cohort Study with Real-time Reporting. Pediatric infectious disease journal, 42(12), 1077-1085. https://doi.org/10.1097/INF.0000000000004098

@article{9a49a99493ce4293aee0e36eb5abe7e9,

title = "Severe Pediatric COVID-19 and Multisystem Inflammatory Syndrome in Children from Wild-type to Population Immunity: A Prospective Multicenter Cohort Study with Real-time Reporting",

abstract = "Background: SARS-CoV-2 variant evolution and increasing immunity altered the impact of pediatric SARS-CoV-2 infection. Public health decision-making relies on accurate and timely reporting of clinical data. Methods: This international hospital-based multicenter, prospective cohort study with real-time reporting was active from March 2020 to December 2022. We evaluated longitudinal incident rates and risk factors for disease severity. Results: We included 564 hospitalized children with acute COVID-19 (n = 375) or multisystem inflammatory syndrome in children (n = 189) from the Netherlands, Cura{\c c}ao and Surinam. In COVID-19, 134/375 patients (36%) needed supplemental oxygen therapy and 35 (9.3%) required intensive care treatment. Age above 12 years and preexisting pulmonary conditions were predictors for severe COVID-19. During omicron, hospitalized children had milder disease. During population immunity, the incidence rate of pediatric COVID-19 infection declined for older children but was stable for children below 1 year. The incidence rate of multisystem inflammatory syndrome in children was highest during the delta wave and has decreased rapidly since omicron emerged. Real-time reporting of our data impacted national pediatric SARS-CoV-2 vaccination- and booster-policies. Conclusions: Our data supports the notion that similar to adults, prior immunity protects against severe sequelae of SARS-CoV-2 infections in children. Real-time reporting of accurate and high-quality data is feasible and impacts clinical and public health decision-making. The reporting framework of our consortium is readily accessible for future SARS-CoV-2 waves and other emerging infections.",

keywords = "COVID-19, MIS-C, pediatrics, real-time reporting, SARS-CoV-2",

author = "Tulling, {Adam J.} and Gertjan Lugthart and Mooij, {Miriam G.} and Brackel, {Caroline L.H.} and Terheggen-Lagro, {Suzanne W.J.} and Rianne Oostenbrink and Buysse, {Corinne M.P.} and Simone Hashimoto and Wineke Armbrust and Bannier, {Michiel A.G.E.} and Jolita Bekhof and {Van Gameren-Oosterom}, {Helma B.} and Han Hendriks and {Van Houten}, {Marlies A.} and {Van Der Linden}, {Jan W.} and Ankie Lebon and {Van Onzenoort-Bokken}, Lonneke and Tramper-Stranders, {Gerdien A.} and {Van Veen}, Mirjam and {Von Asmuth}, {Erik G.J.} and Buddingh, {Emilie P.} and {Van Der Aa}, {Leontien B.} and {Van Aerde}, {Koen J.} and Bettina Auffarth-Smedema and Bart, {Ingeborg Y.} and Cherise Beek and Bechan, {Gitanjali I.} and {Van Den Berg}, {J. Merlijn} and Boonstra, {Venje H.} and Mijke Breukels and Brinkman, {Danielle M.C.} and Bruijning-Verhagen, {Patricia C.J.L.} and {De Crom}, {Stephanie C.} and Ernst-Kruis, {Margot R.} and Fraaij, {Pieter L.A.} and Joyce Goris and Michael Groeneweg and Mariken Gruppen and Hammer, {Sanne C.} and {Hissink Muller}, {Petra C.E.} and {Homan-Van Der Veen}, Jenneke and Jacobs, {Monique A.M.} and Kamps, {Arvid W.A.} and Naomi Ketharanathan and {Van Der Kuip}, Martijn and Kuijpers, {Taco W.} and Legger, {Elizabeth G.} and Shirley Lo-A-Njoe and Manshande, {Meindert E.} and Miedema, {Carien J.} and Obihara, {Charlie C.} and Olivieira, {Gideon O.} and Annemarie Oudshoorn and Peeters, {Esther J.E.} and Ronald Petru and Pijnenburg, {Marielle W.H.} and Denise Rook and Kim Schilleman and Rian Schopmeijer and David Slotboom and {Van Der Steen}, Manouk and Kim Stol and Thomasse, {Yolande E.M.} and Tissing, {Wim J.E.} and {Van Den Tweel}, {Xandra W.} and Vastert, {Sebastiaan J.} and Verbeek, {Anne B.} and {Vernooij-Van Langen}, {Annette M.M.} and Wieringa, {Jantien W.} and Wildenbeest, {Joanne G.} and {De Wildt}, {Saskia N.} and {Van Woerden}, Christiaan",

year = "2023",

month = dec,

doi = "10.1097/INF.0000000000004098",

language = "English",

volume = "42",

pages = "1077--1085",

journal = "Pediatric infectious disease journal",

issn = "0891-3668",

publisher = "LIPPINCOTT WILLIAMS & WILKINS",

number = "12",

}

Tulling, AJ, Lugthart, G, Mooij, MG, Brackel, CLH, Terheggen-Lagro, SWJ, Oostenbrink, R, Buysse, CMP, Hashimoto, S, Armbrust, W, Bannier, MAGE, Bekhof, J, Van Gameren-Oosterom, HB, Hendriks, H, Van Houten, MA, Van Der Linden, JW, Lebon, A, Van Onzenoort-Bokken, L, Tramper-Stranders, GA, Van Veen, M, Von Asmuth, EGJ, Buddingh, EP, Van Der Aa, LB, Van Aerde, KJ, Auffarth-Smedema, B, Bart, IY, Beek, C, Bechan, GI, Van Den Berg, JM, Boonstra, VH, Breukels, M, Brinkman, DMC, Bruijning-Verhagen, PCJL, De Crom, SC, Ernst-Kruis, MR, Fraaij, PLA, Goris, J, Groeneweg, M, Gruppen, M, Hammer, SC, Hissink Muller, PCE, Homan-Van Der Veen, J, Jacobs, MAM, Kamps, AWA, Ketharanathan, N, Van Der Kuip, M, Kuijpers, TW, Legger, EG, Lo-A-Njoe, S, Manshande, ME, Miedema, CJ, Obihara, CC, Olivieira, GO, Oudshoorn, A, Peeters, EJE, Petru, R, Pijnenburg, MWH, Rook, D, Schilleman, K, Schopmeijer, R, Slotboom, D, Van Der Steen, M, Stol, K, Thomasse, YEM, Tissing, WJE, Van Den Tweel, XW, Vastert, SJ, Verbeek, AB, Vernooij-Van Langen, AMM, Wieringa, JW, Wildenbeest, JG, De Wildt, SN & Van Woerden, C 2023, 'Severe Pediatric COVID-19 and Multisystem Inflammatory Syndrome in Children from Wild-type to Population Immunity: A Prospective Multicenter Cohort Study with Real-time Reporting', Pediatric infectious disease journal, vol. 42, no. 12, pp. 1077-1085. https://doi.org/10.1097/INF.0000000000004098

Severe Pediatric COVID-19 and Multisystem Inflammatory Syndrome in Children from Wild-type to Population Immunity: A Prospective Multicenter Cohort Study with Real-time Reporting. / Tulling, Adam J.; Lugthart, Gertjan; Mooij, Miriam G. et al.
In: Pediatric infectious disease journal, Vol. 42, No. 12, 12.2023, p. 1077-1085.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Severe Pediatric COVID-19 and Multisystem Inflammatory Syndrome in Children from Wild-type to Population Immunity

T2 - A Prospective Multicenter Cohort Study with Real-time Reporting

AU - Tulling, Adam J.

AU - Lugthart, Gertjan

AU - Mooij, Miriam G.

AU - Brackel, Caroline L.H.

AU - Terheggen-Lagro, Suzanne W.J.

AU - Oostenbrink, Rianne

AU - Buysse, Corinne M.P.

AU - Hashimoto, Simone

AU - Armbrust, Wineke

AU - Bannier, Michiel A.G.E.

AU - Bekhof, Jolita

AU - Van Gameren-Oosterom, Helma B.

AU - Hendriks, Han

AU - Van Houten, Marlies A.

AU - Van Der Linden, Jan W.

AU - Lebon, Ankie

AU - Van Onzenoort-Bokken, Lonneke

AU - Tramper-Stranders, Gerdien A.

AU - Van Veen, Mirjam

AU - Von Asmuth, Erik G.J.

AU - Buddingh, Emilie P.

AU - Van Der Aa, Leontien B.

AU - Van Aerde, Koen J.

AU - Auffarth-Smedema, Bettina

AU - Bart, Ingeborg Y.

AU - Beek, Cherise

AU - Bechan, Gitanjali I.

AU - Van Den Berg, J. Merlijn

AU - Boonstra, Venje H.

AU - Breukels, Mijke

AU - Brinkman, Danielle M.C.

AU - Bruijning-Verhagen, Patricia C.J.L.

AU - De Crom, Stephanie C.

AU - Ernst-Kruis, Margot R.

AU - Fraaij, Pieter L.A.

AU - Goris, Joyce

AU - Groeneweg, Michael

AU - Gruppen, Mariken

AU - Hammer, Sanne C.

AU - Hissink Muller, Petra C.E.

AU - Homan-Van Der Veen, Jenneke

AU - Jacobs, Monique A.M.

AU - Kamps, Arvid W.A.

AU - Ketharanathan, Naomi

AU - Van Der Kuip, Martijn

AU - Kuijpers, Taco W.

AU - Legger, Elizabeth G.

AU - Lo-A-Njoe, Shirley

AU - Manshande, Meindert E.

AU - Miedema, Carien J.

AU - Obihara, Charlie C.

AU - Olivieira, Gideon O.

AU - Oudshoorn, Annemarie

AU - Peeters, Esther J.E.

AU - Petru, Ronald

AU - Pijnenburg, Marielle W.H.

AU - Rook, Denise

AU - Schilleman, Kim

AU - Schopmeijer, Rian

AU - Slotboom, David

AU - Van Der Steen, Manouk

AU - Stol, Kim

AU - Thomasse, Yolande E.M.

AU - Tissing, Wim J.E.

AU - Van Den Tweel, Xandra W.

AU - Vastert, Sebastiaan J.

AU - Verbeek, Anne B.

AU - Vernooij-Van Langen, Annette M.M.

AU - Wieringa, Jantien W.

AU - Wildenbeest, Joanne G.

AU - De Wildt, Saskia N.

AU - Van Woerden, Christiaan

PY - 2023/12

Y1 - 2023/12

N2 - Background: SARS-CoV-2 variant evolution and increasing immunity altered the impact of pediatric SARS-CoV-2 infection. Public health decision-making relies on accurate and timely reporting of clinical data. Methods: This international hospital-based multicenter, prospective cohort study with real-time reporting was active from March 2020 to December 2022. We evaluated longitudinal incident rates and risk factors for disease severity. Results: We included 564 hospitalized children with acute COVID-19 (n = 375) or multisystem inflammatory syndrome in children (n = 189) from the Netherlands, Curaçao and Surinam. In COVID-19, 134/375 patients (36%) needed supplemental oxygen therapy and 35 (9.3%) required intensive care treatment. Age above 12 years and preexisting pulmonary conditions were predictors for severe COVID-19. During omicron, hospitalized children had milder disease. During population immunity, the incidence rate of pediatric COVID-19 infection declined for older children but was stable for children below 1 year. The incidence rate of multisystem inflammatory syndrome in children was highest during the delta wave and has decreased rapidly since omicron emerged. Real-time reporting of our data impacted national pediatric SARS-CoV-2 vaccination- and booster-policies. Conclusions: Our data supports the notion that similar to adults, prior immunity protects against severe sequelae of SARS-CoV-2 infections in children. Real-time reporting of accurate and high-quality data is feasible and impacts clinical and public health decision-making. The reporting framework of our consortium is readily accessible for future SARS-CoV-2 waves and other emerging infections.

AB - Background: SARS-CoV-2 variant evolution and increasing immunity altered the impact of pediatric SARS-CoV-2 infection. Public health decision-making relies on accurate and timely reporting of clinical data. Methods: This international hospital-based multicenter, prospective cohort study with real-time reporting was active from March 2020 to December 2022. We evaluated longitudinal incident rates and risk factors for disease severity. Results: We included 564 hospitalized children with acute COVID-19 (n = 375) or multisystem inflammatory syndrome in children (n = 189) from the Netherlands, Curaçao and Surinam. In COVID-19, 134/375 patients (36%) needed supplemental oxygen therapy and 35 (9.3%) required intensive care treatment. Age above 12 years and preexisting pulmonary conditions were predictors for severe COVID-19. During omicron, hospitalized children had milder disease. During population immunity, the incidence rate of pediatric COVID-19 infection declined for older children but was stable for children below 1 year. The incidence rate of multisystem inflammatory syndrome in children was highest during the delta wave and has decreased rapidly since omicron emerged. Real-time reporting of our data impacted national pediatric SARS-CoV-2 vaccination- and booster-policies. Conclusions: Our data supports the notion that similar to adults, prior immunity protects against severe sequelae of SARS-CoV-2 infections in children. Real-time reporting of accurate and high-quality data is feasible and impacts clinical and public health decision-making. The reporting framework of our consortium is readily accessible for future SARS-CoV-2 waves and other emerging infections.

KW - COVID-19

KW - MIS-C

KW - pediatrics

KW - real-time reporting

KW - SARS-CoV-2

UR - http://www.scopus.com/inward/record.url?scp=85177103178&partnerID=8YFLogxK

U2 - 10.1097/INF.0000000000004098

DO - 10.1097/INF.0000000000004098

M3 - Article

C2 - 37823702

AN - SCOPUS:85177103178

SN - 0891-3668

VL - 42

SP - 1077

EP - 1085

JO - Pediatric infectious disease journal

JF - Pediatric infectious disease journal

IS - 12

ER -

Severe Pediatric COVID-19 and Multisystem Inflammatory Syndrome in Children from Wild-type to Population Immunity: A Prospective Multicenter Cohort Study with Real-time Reporting

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