Biochemical and cardiovascular predictors of PIMS-TS risk in children after COVID-19 recovery: preliminary results of the LATE-COVID-Kids Study

Abstract

IntroductionWe aimed to characterize biochemical and cardiovascular predictors of paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) risk based on the data from the LATE-COVID-Kids study.Material and methods148 consecutive COVID-19 convalescents hospitalized for the clinical evaluation after the acute phase of COVID-19 were classified into two groups related to symptoms: 33 children finally diagnosed with PIMS-TS and 115 children without PIMS-TS (control group).ResultsPIMS-TS children were significantly younger (6.79 ±4.57 vs. 9.10 ±4.94 years). After adjustment, in comparison to those without, PIMS-TS children had a higher level of antithrombin III (111 ±9.30 vs. 105 ±11.4), higher heart rate (HR)/min (100 (89.0–111) vs. 90 (79.7–100)) and sinus rhythm (p = 0.03) but lower PQ interval (p = 0.02) on admission to hospital. The lymphocytes (absolute count and percentage) were significantly higher in children with PIMS-TS, and the opposite results were obtained for IgA and neutrophils. Furthermore, children with PIMS-TS had a higher level of thyroid stimulating hormone (2.76 (2.16–4.18) vs. 2.36 (1.73–2.83)) and red cell distribution width (p < 0.005) compared to those without.ConclusionsIt is the first data on the possible predictors of PIMS-TS risk in the Long-COVID period. These results need to be further validated to next create the PIMS SCORE algorithm, which might enable the effective prediction of children with the risk of PIMS-TS occurrence after COVID-19 recovery.

"LC Risk Score" - development and evaluation of a scale for assessing the risk of developing long COVID

“…The Polish data also confirm the phenomenon's local spread at a high level [6]. Potential risk factors for developing complications after COVID-19 include age, female sex, severe course of COVID-19, and coexistence of comorbidities [6][7][8][9].…”

Long-term effect of SARS-CoV-2 infection on cardiovascular outcomes and all-cause mortality

“…Later, a growing number of children developed inflammatory systemic symptoms that appeared weeks after the initial infection of COVID-19. This clinical entity, defined as multisystem inflammatory syndrome in children (MIS-C) or Kawasaki-like disease, includes prolonged fever, gastrointestinal symptoms, cutaneous signs, neurological alterations and cardiovascular manifestations such as myocarditis with ventricular dysfunction, coronary artery aneurysms, arrhythmias [66] , [67] . MIS-C is burdened by high possibility of morbidity, complications, and adverse outcomes [67] , but its incidence is still not well defined [68] , [69] .…”

Pro-inflammatory and anti-inflammatory cytokines as candidate markers in the diagnosis and assessment of Crohn's disease activity

“…Overall, the analysis of the immune response cannot be overestimated in clinical practice, as demonstrated in the LATE-COVID-Kids Study of the pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) [44].…”