Signs, Symptoms Vary Widely for Children Presenting With PIMS-TS

Pediatric inflammatory multisystem syndrome temporally linked to SARS-CoV-2 is poorly understood

sick child in hospital

FRIDAY, June 12, 2020 (HealthDay News) -- Children presenting with pediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; PIMS-TS) have a wide range of presenting symptoms, according to a study published online June 8 in the Journal of the American Medical Association.

Elizabeth Whittaker, M.D., from the Imperial College Healthcare NHS Trust in London, and colleagues describe the clinical and laboratory characteristics of 58 children with PIMS-TS from eight hospitals in England admitted between March 23 and May 16, 2020. Characteristics were compared to those of 1,132 patients with Kawasaki disease (KD), 45 with KD shock syndrome, and 37 with toxic shock syndrome.

The researchers found that 45 of the 58 patients had evidence of current or prior SARS-CoV-2 infection. All presented with fever and nonspecific symptoms, including vomiting, abdominal pain, and diarrhea (45, 53, and 52 percent, respectively). In addition, rash and conjunctival injection were present in 52 and 45 percent of cases, respectively. Laboratory assessment was consistent with marked inflammation. Twenty-nine of the children developed shock, with biochemical evidence of myocardial dysfunction, and required inotropic support and fluid resuscitation; 13 met the American Heart Association definition of KD. Coronary artery dilatation or aneurysm developed in eight patients. Compared with patients with KD and KD shock syndrome, those with PIMS-TS were older and had greater elevation of inflammatory markers.

"The comparison with patients with KD and KD shock syndrome provides insights into this syndrome, and suggests this disorder differs from other pediatric inflammatory entities," the authors write.

One author disclosed financial ties to pharmaceutical and medical device companies.

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