Inflammatory syndrome linked to kids with COVID only occurs in 0.3%

Inflammatory syndrome linked to kids with COVID is rare – only occurring in about 0.3% of children – but black and Latino youngsters are up to THREE TIMES more likely than whites to get it

  • A new study looked at 248 cases of MIS-C in pediatric patients with coronavirus out of more than nine million children
  • MIS-C is a condition in which different body parts become inflamed and is linked to children infected with COVID-19 
  • Researchers determined the incidence rate was 316 persons per 1,000,000 coronavirus infections, or a rate of 0.3%
  • Black children were two times more likely than white children and Hispanic almost three times more likely to be diagnosed with MIS-C
  • Rates were highest among those under age five, and higher among six-10-year-olds, than in older children 

A very small percentage of children develop the inflammatory condition linked to COVID-19, a new study suggests.

Researchers found that just 0.3 percent of youngsters under age 21 were diagnosed with multisystem inflammatory syndrome in children (MIS-C), a disorder in which different body parts become inflamed.

The complication was most common in kids under age five, and black and Hispanic children were up to three times more likely to have the condition than white youngsters.

It’s not clear why minorities are at greater risk of MIS-C, but theories include a greater prevalence of underlying conditions among communities of color and less access to healthcare compared to Caucasian neighborhoods.

The team, from the Centers for Disease Control and Prevention (CDC), says understanding which children are at the highest risk can help doctors keep a close eye on certain patients so they can be treated before they develop MIS-C. 

A new study looked at 248 cases of MIS-C, a condition in which different body parts become inflamed, in pediatric patients with coronavirus out of more than nine million. Pictured: A five- year-old child in a hospital bed at Westchester Medical Center in Valhalla, New York, May 2020

Black children were two times more likely than white children and Hispanic almost three times more likely to be diagnosed with MIS-C, a new study finds

MIS-C was originally thought to be linked with Kawasaki disease, a condition that causes inflammation in the walls of the blood vessels and affects mostly children under five years old.

Cases were first reported in Britain, Italy and Spain in April 2020 and began cropping up in the U.S. in May.

A total of 4,018 cases have been confirmed across the country and at least 36 children have died, according to the CDC.

The majority of children and adolescents develop MIS-C between two and four weeks after being infected with the coronavirus.

Not every child who has developed the condition has tested positive for coronavirus, but 98 percent have – enough for doctors to believe the conditions are linked.

For the study, published in JAMA Network Open, the team looked at data from seven states reporting cases of MIS-C to the CDC.

Between April and June 2020, there were 248 reported cases that occurred in Americans under age 21 out of more than nine million children.

Researchers determined the incidence rate was 316 persons per 1,000,000 coronavirus infections, or a rate of 0.3 percent.

MIS-C rates were highest among those under age five, and higher among six-10-year-olds, than in older children

When broken down by race, about 30.2 percent, or 75 kids, were black and 38.7 percent, 96 kids, were Hispanic.

Comparatively, just 13.7 percent – 34 kids – were white. 

That means black children were two times more likely and Hispanic almost three times more likely to be diagnosed with MIS-C.

Additionally, younger children were much more likely to have the condition than older children.

Those under five years old were the most likely at 33 percent, closely followed by those ages six to 10.

‘These estimates indicated that MIS-C was a rare complication associated with SARS-CoV-2 infection in this cohort overall,’ the authors wrote.

‘Our findings of higher incidence among younger children and among Hispanic or Latino, black, and Asian or Pacific Islander persons emphasize a need for further study of risk factors for MIS-C.’

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Gut microbiota reveal whether drug therapies work in inflammatory bowel diseases

Gut microbiota reveals whether drug therapies work in inflammatory bowel diseases

The prevalence of inflammatory bowel diseases has significantly increased both in Finland and globally. These disorders cannot be entirely cured. Instead, they are treated with anti-inflammatory drugs and, at times, through surgery.

If conventional drug therapies based on anti-inflammatory drugs are ineffective, the diseases can be treated using infliximab, a biological TNF-α blocker that is administered intravenously. Infliximab is an antibody that prevents TNF-α, a pro-inflammatory factor, from binding with inflammatory cells in the intestine. It is effective in reducing inflammation and improving the patient’s condition, while also controlling the disease well.

Although infliximab therapy is often effective, roughly 30-40% of patients either do not respond to the treatment or lose response over time. So far, no reliable tests for predicting treatment response are available.

“A test for predicting responses would help to choose drug therapies and avoid unnecessary drug use, which would reduce potential adverse effects and save on drug expenses in the healthcare system,” postdoctoral researcher Eija Nissilä says.

In a collaborative project, the University of Helsinki and the Department of Gastroenterology at the Helsinki University Hospital investigated whether any predictors associated with infliximab therapy could be identified in the gut microbiota. The results were published in the Journal of Crohn’s and Colitis.

The study revealed that already before treatment the gut microbiota of inflammatory bowel disease patients differed in terms of several bacterial and fungal genera. These differences had a link to infliximab therapy response.

The changes that occurred in the gut microbiota during therapy also differed between patients who presented a response to treatment and those who did not. The gut of non-responsive patients had fewer anti-inflammatory bacteria of the Clostridia family and a higher number of pro-inflammatory bacteria and fungi such as Candida. Certain bacteria found in the intestine predicted a good response to infliximab therapy.

Based on the results, gut bacteria and fungi could potentially be used as indicators when assessing whether to initiate treatment or not.

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People with inflammatory bowel disease still die earlier despite increase in life

A study comparing life expectancy of people with inflammatory bowel disease (IBD) and without found that, while life expectancy increased for both groups, people with IBD generally died sooner. The study is published in CMAJ (Canadian Medical Association Journal).

“The good news is life expectancy has increased in people with IBD, but there is still a gap between people with and without the disease,” says Dr. Eric Benchimol, a senior core scientist at ICES, and a pediatric gastroenterologist who works at The Hospital for Sick Children (SickKids). “However, people with IBD suffer from pain, which can negatively affect daily functioning and contribute to decreased health-adjusted life expectancy.”

The study included 32 818 people living with IBD in 1996 (matched to 163 284 people without IBD), increasing to 83 672 in 2011 (matched to 418 360 people without IBD). In women with IBD, life expectancy increased by almost 3 years between 1996 (75.5 years) and 2011 (78.4 years). Life expectancy among men with IBD increased by 3.2 years between 1996 and 2011, from 72.2 years to 75.5 years.

However, people with IBD had a consistently shorter life expectancy than those without IBD. Women with IBD can expect to live between 6.6 years and 8.1 years less than women without IBD. Men with IBD can expect to live between 5.0 years and 6.1 years less than men without IBD. When measuring health-adjusted life expectancy, a measure of how health-related symptoms and functioning affects both quality of life and life expectancy, the gap between those with and without IBD was even greater. Women with IBD have a health-adjusted life expectancy that is 9.5 to 13.5 years shorter than women without IBD. Men with IBD have a health-adjusted life expectancy that is 2.6 to 6.7 years shorter than men without IBD.

Patients with IBD often experience inflammation beyond the intestinal tract and are more likely to be diagnosed with cancer, heart disease, arthritis and other conditions.

“In light of the increasing prevalence of IBD in Canada, and the frequency of pain in patients with IBD and its impact on health-related quality of life, we need to develop better pain-management strategies,” says Dr. Ellen Kuenzig, the study’s lead author and a postdoctoral fellow at ICES and the CHEO Research Institute in Ottawa.

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