Educational Setting and SARS-CoV-2 Transmission Among Children With Multisystem Inflammatory Syndrome: A French National Surveillance System

Celia Guenver (1, 2) , Mehdi Oualha (3) , Corinne Levy (4, 5, 6) , Denise Antona (7) , Fouad Madhi (6) , Julie Toubiana (8, 3) , Noémie Lachaume (9) , Etienne Javouhey (10, 11) , Mathie Lorrot (12) , David Dawei Yang (3) , Michael Levy (1) , Marion Caseris (1) , Caroline Galeotti (13, 14) , Caroline Ovaert (15, 16) , Arnaud Wiedemann (17, 18) , Marie-Laure Girardin (19) , Alexis Rybak (1) , Robert Cohen (4, 6) , Alexandre Belot (20, 14) , François Angoulvant (21, 22) , Naïm Ouldali (23, 1, 4)

1 AP-HP Hôpital universitaire Robert-Debré [Paris]
2 SU - Sorbonne Université
3 Hôpital Necker - Enfants Malades [AP-HP]
4 ACTIV - Association Clinique et Thérapeutique Infantile du Val de Marne
5 IMRB - Institut Mondor de Recherche Biomédicale
6 CHIC - Centre Hospitalier Intercommunal de Créteil
7 Santé publique France - French National Public Health Agency [Saint-Maurice, France]
8 Biodiversité et Epidémiologie des Bactéries pathogènes - Biodiversity and Epidemiology of Bacterial Pathogens
9 Hôpital Louis Mourier - AP-HP [Colombes]
10 PI3 - Physiopathologie de l'immunodépression associée aux réponses inflammatoires systémiques / Pathophysiology of Injury-induced Immunosuppression
11 HCL - Hospices Civils de Lyon
12 CHU Trousseau [APHP]
13 Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
14 AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP)
15 MMG - Marseille medical genetics - Centre de génétique médicale de Marseille
16 TIMONE - Hôpital de la Timone [CHU - APHM]
17 NGERE - Nutrition-Génétique et Exposition aux Risques Environnementaux
18 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
19 Hôpital de Hautepierre [Strasbourg]
20 CIRI - Centre International de Recherche en Infectiologie
21 HeKA - Health data- and model- driven Knowledge Acquisition
22 CRC (UMR_S_1138 / U1138) - Centre de Recherche des Cordeliers
23 ECEVE (U1123 / UMR_S_1123) - Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables

Background: Multisystem inflammatory syndrome in children (MIS-C) is the most severe form associated with SARS-CoV-2 infection in children. To reduce the spread of SARS-CoV-2 at the population level, educational setting closure have been implemented in many countries. However, the direct benefit of school closure on the MIS-C burden remains to be explored. We aimed to assess the role of educational settings in SARS-CoV-2 transmission among children with MIS-C. Methods: We conducted a French national prospective surveillance of MIS-C, coordinated by Public Health France, from April 2020 to March 2021. During this period, we included all children with MIS-C fulfilling the WHO definition who were reported to Public Health France. For each child, we traced the source of SARS-CoV-2 transmission. The main outcome was the proportion of children with MIS-C, with educational setting-related SARS-CoV-2 infection, during the period of school opening. Results: We included 142 children fulfilling WHO criteria for MIS-C: 104 (70%) cases occurred during school opening periods. In total, 62/104 children (60%, 95%CI [50; 69]) had been contaminated by a household contact and 5/104 in educational settings (5%, 95%CI [2; 11]). Among children with MIS-C occurring during school closure periods, the proportion of household transmission remained similar (66%, 25/38). Conclusion: Children with MIS-C were mainly infected by SARS-CoV-2 within their family environment, and the educational setting played a marginal role in this transmission. This suggests that mitigating school attendance may not reduce substantially the burden of MIS-C.

Mots clés: Multisystem inflammatory syndrome in children (MIS-C); Educational setting; SARS-CoV-2; School; Pediatrics-children

Domaines: Maladies infectieuses; Maladies émergentes; Pédiatrie; Santé publique et épidémiologie

Celia Guenver, Mehdi Oualha, Corinne Levy, Denise Antona, Fouad Madhi, et al.. Educational Setting and SARS-CoV-2 Transmission Among Children With Multisystem Inflammatory Syndrome: A French National Surveillance System. Frontiers in Pediatrics, 2021, 9, pp.745364. ⟨10.3389/fped.2021.745364⟩. ⟨hal-03446710⟩