Paediatric inflammatory multisystem syndrome - temporally associated with SARS-CoV-2 (PIMS-TS) - a German single centre real-life evaluation of the Swiss and UK consensus statements.

Abstract

BACKGROUND:

In the absence of randomised trials for paediatric multisystem inflammatory syndrome temporally associated with SARS-CoV2 (PIMS-TS), optimal management of PIMS-TS-patients remains somewhat uncertain. We aimed to evaluate the practicability of consensus diagnostic/therapeutic pathways in a real-life German hospital setting.

METHODS:

All children treated for PIMS-TS (February to November, 2021) at the Childrens' Hospital Kassel were analysed retrospectively. Patients were treated according to local PIMS-TS standardised operating procedure based on the Swiss and UK consensus statements.

RESULTS:

Eleven patients treated for PIMS-TS were included in this study (female:male = 2.1:1). According to the categories of the Swiss and UK consensus statements, 36% were uncomplicated hyperinflammation, 36% Kawasaki-like and 27% shock-like disease. Local estimated incidence was 0.92/1000 Covid-19 cases in children aged 4-15 years. Significant inter-group differences in laboratory parameters were found: BNP was highest in shock-like presentation compared to Kawasaki-like and uncomplicated hyperinflammation (median 954 (668-1491) versus 213 (173-934) versus 80 (5-257) ng/l, p = 0.02), whereas troponin was highest in Kawasaki-like, followed by shock-like presentation and uncomplicated hyperinflammation (median 34.7 (27.5-58.4) versus 19.1 (14.1-23.4) versus 1.9 (1.9-16.4) ng/l, p = 0.02). Patients with shock-like presentation needed circulatory resuscitation in the paediatric ICU. All patients received standardised operating procedure-based therapy and were discharged home after a medium of 7.4 days.

CONCLUSION:

The Swiss and UK consensus statements on the management of PIMS-TS proved very valuable in a real-life clinical setting, facilitated early categorisation, and initiation of specific therapy, possibly improving the outcome. Additional randomised trials are necessary to further improve the management of PIMS-TS.

• Authors: Andreas Jenke, Michael Steinmetz
• Journal: Cardiology in the young (Cardiol Young) Vol. 33 Issue 4 Pg. 546-550 (Apr 2023) ISSN: 1467-1107 [Electronic] England
• PMID: 35546290 (Publication Type: Journal Article)

Chemical References

• RNA, Viral

Topics

• Child
• Humans
• Female
• Male
• COVID-19 (therapy)
• SARS-CoV-2
• RNA, Viral
• Retrospective Studies
• Switzerland (epidemiology)
• United Kingdom