Zambrano, Laura D.Wu, Michael J.Martin, LoraMalloch, LacyChen, SabrinaNewhams, Margaret M.Kucukak, SudenSon, Mary BethSanders, CameronPatterson, KaylaHalasa, NatashaFitzgerald, Julie C.Leroue, Matthew K.Hall, MarkIrby, KatherineRowan, Courtney M.Wellnitz, KariSahni, Leila C.Loftis, LauraBradford, Tamara T.Staat, MaryBabbitt, ChristopherCarroll, Christopher L.Pannaraj, Pia S.Kong, MicheleSchuster, Jennifer E.Chou, JanetPatel, Manish M.Randolph, Adrienne G.Campbell, Angela P.Hobbs, Charlotte V.Overcoming COVID-19 investigators2024-01-262024-01-262023Zambrano LD, Wu MJ, Martin L, et al. Risk Factors for Multisystem Inflammatory Syndrome in Children: A Case-control Investigation. Pediatr Infect Dis J. 2023;42(6):e190-e196. doi:10.1097/INF.0000000000003900https://hdl.handle.net/1805/38224Background: In a 2020 pilot case-control study using medical records, we reported that non-Hispanic Black children were more likely to develop multisystem inflammatory syndrome in children (MIS-C) after adjustment for sociodemographic factors and underlying medical conditions. Using structured interviews, we investigated patient, household, and community factors underlying MIS-C likelihood. Methods: MIS-C case patients hospitalized in 2021 across 14 US pediatric hospitals were matched by age and site to outpatient controls testing positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within 3 months of the admission date. Caregiver interviews queried race/ethnicity, medical history, and household and potential community exposures 1 month before MIS-C hospitalization (case-patients) or after SARS-CoV-2 infection (controls). We calculated adjusted odds ratios (aOR) using mixed-effects multivariable logistic regression. Results: Among 275 case patients and 496 controls, race/ethnicity, social vulnerability and patient or family history of autoimmune/rheumatologic disease were not associated with MIS-C. In previously healthy children, MIS-C was associated with a history of hospitalization for an infection [aOR: 4.8; 95% confidence interval (CI): 2.1-11.0]. Household crowding (aOR: 1.7; 95% CI: 1.2-2.6), large event attendance (aOR: 1.7; 95% CI: 1.3-2.1), school attendance with limited masking (aOR: 2.6; 95% CI: 1.1-6.6), public transit use (aOR: 1.8; 95% CI: 1.4-2.4) and co-resident testing positive for SARS-CoV-2 (aOR: 2.2; 95% CI: 1.3-3.7) were associated with increased MIS-C likelihood, with risk increasing with the number of these factors. Conclusions: From caregiver interviews, we clarify household and community exposures associated with MIS-C; however, we did not confirm prior associations between sociodemographic factors and MIS-C.en-USPublisher PolicyChildrenCoronavirus disease 2019 (COVID-19)Multisystem inflammatory syndrome in childrenSARS-CoV-2Risk factorsArticle