Paediatric Multisystem Inflammatory Syndrome Temporally Associated with SARS-CoV-2 (PIMS-TS): Prospective, National Surveillance, UK and Ireland, 2020

Crossing the Rubicon: A fine line between waiting and vaccinating adolescents against COVID-19

“…Additionally, an unexpected complication of SARS-CoV-2 infection in children was the emergence of Paediatric Multisystem Inflammatory Syndrome (PIMS-TS), a hyperinflammatory syndrome temporally associated with SARS-CoV-2, with features of Kawasaki disease and toxic shock syndrome, and also known as Multisystem Inflammatory Syndrome in Children (MIS-C) 19 PIMS-TS occurs 2-4 weeks after exposure to SARS-CoV-2 19 , and one study using cases in the United States estimate an incidence of 316 per million SARS-CoV-2 infections (3/10,000 or 0.03%) in 0-20 year-olds, including 197 per million SARS-CoV-2 infections (2/10,000 or 0.02%) among 11-15 year-olds 20 . Children with PIMS-TS typically present with fever and features of circulatory shock with cardiac involvement, gastrointestinal symptoms and elevated markers of inflammation 19 , 21 . Complications include cardiac dysfunction, shock, myocarditis, coronary artery dilatation or aneurysm, and acute kidney injury, with more than half the children requiring paediatric intensive care admission, and an overall case fatality rate of 1-2% 19 , 21 .…”

“…Children with PIMS-TS typically present with fever and features of circulatory shock with cardiac involvement, gastrointestinal symptoms and elevated markers of inflammation 19 , 21 . Complications include cardiac dysfunction, shock, myocarditis, coronary artery dilatation or aneurysm, and acute kidney injury, with more than half the children requiring paediatric intensive care admission, and an overall case fatality rate of 1-2% 19 , 21 . Vaccinating adolescents would, therefore, potentially reduce the risk of COVID-19 and PIMS-TS, resulting in fewer hospitalisations, intensive care admissions, long COVID cases and death, although the numbers needed to vaccinate to prevent these rare outcomes in adolescents would likely be very large and assumes that those who are most at risk of disease will have the vaccine when offered.…”

Study protocol: Medium throughput, deep proteomic characterization of children with PIMS-TS, and identification of candidate diagnostic biomarkers

“…The copyright holder for this this version posted December 28, 2022. ; https://doi.org/10.1101/2022.12.27.22283890 doi: medRxiv preprint cases, with some children very unwell, requiring ICU admission, usually for inotropic support, while other children can be managed in a ward setting without the need for inotropes. [15] Misdiagnosing a child with an acute severe viral or bacterial infection with PIMS-TS is a possibility, given the similarities in their initial condition when presenting. It would be clinically useful to have a diagnostic biomarker or panel of biomarkers which can be used to identify children with PIMS-TS.…”