Clinical profile and management of patients with pediatric inflammatory multisystem syndrome – temporally associated with SARS-CoV-2 – single-center experience

Abstract

Introduction and aim. Pediatric Inflammatory Multisystem Syndrome (PIMS-TS) is a new condition that has emerged in children during the COVID-19 pandemic. Many clinical signs and symptoms resemble those found in Kawasaki disease (KD). Material and methods. The following data were considered: clinical presentation, comorbidities, laboratory findings, abnormalities in additional tests, exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the child and his family members, applied treatment and return to full health. Results. In the presented study nineteen children were analyzed. Fever was a universal finding in our group and it’s mean duration was 7 days (range 5-9). Other common symptoms included abdominal pain and severe weakness (in 89.5%), rash and conjunctivitis (in 84.2%), vomiting (in 73.7%) and mucous membrane involvement (in 63.2%). In nearly half of cases, echocardiography revealed fluid in the pericardial sac and left ventricular systolic dysfunction (in 52.6% and 47.4% respectively). 21.1% of patients had coronary artery abnormalities. 26,3% of the children required treatment with dopamine and/or milrinone. In 15.7% ICU admissions and assisted ventilation was necessary. No deaths were recorded. Conclusion. One should bear in mind that PIMS-TS can mimic KD, appendicitis and meningitis, which may pose a diagnostic challenge.