Context

Multisystem inflammatory syndrome in children (MIS-C), also known as pediatric inflammatory multisystem syndrome, is a new dangerous childhood disease that is temporally associated with coronavirus disease 2019 (COVID-19). We aimed to describe the typical presentation and outcomes of children diagnosed with this hyperinflammatory condition.

https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30271-6/fulltext#seccesectitle0001

Content

A systematic review to communicate the clinical signs and symptoms, laboratory findings, imaging results, and outcomes of individuals with MIS-C.

Acknowledgements

Authors: Mubbasheer Ahmeda;; , Shailesh Advanib;; Axel Moreira;; , Sarah Zoretic;; , John Martinez;; Kevin Chorath;; , Sebastian Acosta;; , Rija Naqvi;; Finn Burmeister-Morton;; Fiona Burmeister;; Aina Tarriela;; , Matthew Petershack;; , Mary Evans;; , Ansel Hoang;; Karthik Rajasekaran;; , Sunil Ahuja;; Alvaro Moreira

Department of Pediatrics, Texas Children’s Hospital, Houston, TX, USA;; Department of Oncology, Georgetown University, Washington, DC, USA;; Social Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, USA;; Department of Pediatrics, University of Texas Health Science Center San Antonio, San Antonio, TX 78229-3900, USA;; Department of Otorhinolaryngology, The University of Pennsylvania, Philadelphia, PA, USA.

Photo by L N on Unsplash

Inspiration

Covid-19 Pandemic.

Background: Limited information is available for patients with breast cancer (BC) and coronavirus disease 2019 (COVID-19), especially among underrepresented racial/ethnic populations. Methods: This is a COVID-19 and Cancer Consortium (CCC19) registry-based retrospective cohort study of females with active or history of BC and laboratory-confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection diagnosed between March 2020 and June 2021 in the US. Primary outcome was COVID-19 severity measured on a five-level ordinal scale, including none of the following complications, hospitalization, intensive care unit admission, mechanical ventilation, and all-cause mortality. Multivariable ordinal logistic regression model identified characteristics associated with COVID-19 severity. Results: 1,383 female patient records with BC and COVID-19 were included in the analysis, the median age was 61 years, and median follow-up was 90 days. Multivariable analysis revealed higher odds of COVID-19 severity for older age (aOR per decade, 1.48 [95% CI, 1.32–1.67]); Black patients (aOR 1.74; 95 CI 1.24–2.45), Asian Americans and Pacific Islander patients (aOR 3.40; 95 CI 1.70–6.79) and Other (aOR 2.97; 95 CI 1.71–5.17) racial/ethnic groups; worse ECOG performance status (ECOG PS ≥2: aOR, 7.78 [95% CI, 4.83–12.5]); pre-existing cardiovascular (aOR, 2.26 [95% CI, 1.63–3.15])/pulmonary comorbidities (aOR, 1.65 [95% CI, 1.20–2.29]); diabetes mellitus (aOR, 2.25 [95% CI, 1.66–3.04]); and active and progressing cancer (aOR, 12.5 [95% CI, 6.89–22.6]). Hispanic ethnicity, timing, and type of anti-cancer therapy modalities were not significantly associated with worse COVID-19 outcomes. The total all-cause mortality and hospitalization rate for the entire cohort were 9% and 37%, respectively; however, it varied according to the BC disease status. Conclusions: Using one of the largest registries on cancer and COVID-19, we identified patient- and BC-related factors associated with worse COVID-19 outcomes. After adjusting for baseline characteristics, underrepresented racial/ethnic patients experienced worse outcomes compared to Non-Hispanic White patients.