Paediatric Inflammatory Multisystem Syndrome Temporally Associated with Sars-Cov-2: A Review and Our Experience in a Secondary Hospital in Spain

Abstract

Introduction: Paediatric multisystem inflammation syndrome temporally associated with SARS-COV-2 (PIMS-TS was described in 2020 as an increased incidence of paediatric patients with cardiogenic shock and acute myocarditis associated with SARS-COV2. This disease has similarities and can manifest as Kawasaki Disease (KD). The aim of the study was to document the cardiovascular characteristics of the novel multisystem inflammatory syndrome in children and to share our experience. Methods: A descriptive study is presented including children with diagnosis of PIMS- TS at a secondary hospital. Children 0 to 15 years of age admitted to a hospital between from May 2020 to May 2021 were included and the data, including demography, clinical status, biochemical markers, echocardiography findings, treatment and evolution, were extracted from the clinical history of the patients. Results: 7 children were included from a secondary hospital. The mean age was 8 years and 71% were boys. The most common cardiovascular complications were cardiovascular shock with hypotension and the reduction in over a half of the patients in the left ventricular ejection fraction was reported. It was observed a high elevation of acute phase reactants at the admission. In 2 children were found coronary alterations. Polymerase chain reaction (PCR) for SARS-COV-2 was positive in 28% whereas immunoglobulin G (IgG) was positive in 100% cases. Conclusion: Covid-19 disease is asymptomatic in children in most cases but cardiovascular involvement is common if PIMS-TS is presented. Despite the need of intensive care support, mortality is uncommon and our study shows that these patients can be treated in a hospital with Paediatric Intensive Critical Unit level 2 benefiting from combined, specific treatment.