Abstract 16216: Sociodemographic Disparities in Severity of Multisystem Inflammatory Syndrome in Children: The National MUSIC Study
Keila N Lopez, Dongngan Truong, Brett R Anderson, Carissa M Baker-Smith, Tamara T Bradford, Audrey Dionne, Kirsten Dummer, Daniel E Forsha, Wayne J Franklin, Stephanie Handler, Ashraf S Harahsheh, Keren Hasbani, Chenwei hu, Pei-Ni Jone, Sean Lang, Kimberly E McHugh, Matthew Oster, Gail D Pearson, Michael A Portman, Tamar Preminger, Mark Russell, Yamuna Sanil, S Sexson Tejtel, Divya Shakti, Ryan Shea, Felicia Trachtenberg, Shuo Wang, Jonathan P. P Wong, Jane W Newburger- Physiology (medical)
- Cardiology and Cardiovascular Medicine
Introduction: The long-term outcomes after the Multisystem Inflammatory Syndrome in Children (MUSIC) study investigates sequelae in multisystem inflammatory syndrome (MIS-C) post-COVID across 33 US and Canadian sites. Among children with COVID-19, the adjusted MIS-C incidence rate ratios are higher in children who are Hispanic or Black. Our objective was to assess sociodemographic disparities associated with MIS-C severity and adverse outcomes.
Methods: This multicenter cross-sectional study included US persons <21 years-old with MIS-C from 6/2020-1/2022. The primary composite outcome of greater illness severity included
Results: There were 1115 MIS-C patients, with a median age of 9 years old (IQR 5.6, 12.7), 39.2% female, 28.1% non-Hispanic Black, 27.8% Hispanic, 47.3% with public insurance, and a median SDI of 54 (IQR 25.0, 82.5). On multivariable analysis, increased odds of more severe illness included Hispanic ethnicity, odds ratio (OR) 1.5 (95% CI 1.1, 2.2); non-Hispanic Black race, OR 1.7 (95% CI 1.1, 2.4) compared to non-Hispanic whites; and ages 13-17 years, OR 3.7 (95% CI 2.4, 5.6) compared to those ages 0-5 years. Longer time to hospital admission was associated with lower SDI (i.e., less deprivation; p=0.009) and further distance from hospital (p=0.006). Risk factors for longer LOS were adolescent age (p=0.002) and non-Hispanic Black race (p=0.018). Asthma and obesity had no association with MIS-C severity.
Conclusion: MIS-C severity and adverse outcomes are associated with sociodemographic factors, including being Black and/or Hispanic. Future studies should explore risk mechanisms , including systemic racism, environmental and genetic causes, quality of medical care, or multifactorial interactions.