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July 22, 2020
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Syndrome linked to COVID-19 disproportionately affects Black, Hispanic and Latino children

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As of July 15, three dozen states and Washington, D.C., reported a total of 342 cases of a serious new inflammatory condition in children that has been associated with COVID-19.

Of the total number of cases of multisystem inflammatory syndrome in children (MIS-C), 71% have been reported in children who are either Black, Hispanic or Latino — 38% in Black children (n = 104) and 33% in Hispanic or Latino children (n = 120), according to CDC data.

Race or ethnicity of patients with MIS-C.
Race or ethnicity of patients with MIS-C.

“The disproportionate appearance of MIS-C in children of color is striking and requires further study,” David Cennimo, MD, a clinician and assistant professor of adult infectious diseases at Rutgers New Jersey Medical School, told Healio. “It does recapitulate the disparities we are seeing with COVID-19 ravaging Black and Hispanic U.S. communities. We know these communities have [a] higher incidence and more severe infections than their white counterparts.”

The CDC’s case definition for MIS-C includes a patient aged younger than 21 years who presents with a fever, has evidence of inflammation and has multisystem organ involvement, no alternative plausible diagnoses and is positive for current or recent SARS-CoV-2 infection or has been exposed to COVID-19 within the 4 weeks before developing symptoms. Pediatricians and parents can review AAP guidelines on MIS-C.

Of the 342 cases reported so far, 96% of children (n = 329) tested positive for SARS-CoV-2. According to the CDC, the remaining 4% of children were reportedly exposed to someone with COVID-19.

Cennimo said he was reminded of a study published in JAMA that described the clinical characteristics of 58 hospitalized children with MIS-C in England.

David Cennimo

“Of those 58, 38% were Black, 31% Asian, and 10% other; they also noted a male predominance — 66%. This is definitely an evolving issue, one we should all watch closely,” Cennimo said.

According to the CDC data, 55% of U.S. cases are in male children.

Currently, there is not a clear reason as to why some children may be more susceptible. Cennimo suggested that genetics may play a role.

References:

  • CDC. Health department-reported cases of multisystem inflammatory syndrome in children (MIS-C) in the United States. https://www.cdc.gov/mis-c/cases/index.html. Accessed July 22, 2020.