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You are here: Home / Articles / Generally Favorable Outcomes 6 Months After COVID-Linked Inflammatory Syndrome in Kids

Generally Favorable Outcomes 6 Months After COVID-Linked Inflammatory Syndrome in Kids

July 15, 2021 • By Reuters Staff

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NEW YORK (Reuters Health)—A six-month assessment of children with pediatric inflammatory multisystem syndrome temporally associated with COVID-19 disease (PIMS-TS) show generally favorable outcomes, but also a range of lingering issues.

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Cardiac, gastrointestinal, renal, hematology and otolaryngology problems largely resolved at six months, but muscular fatigue and emotional lability were common. Long-term, serious end-organ damage occurred in some patients but was uncommon, researchers report in the Lancet Child and Adolescent Health.1

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“This analysis highlights the importance of physical rehabilitation and mental health provision for patients with PIMS-TS following discharge from hospital,” says Karyn Moshal, MD, with Great Ormond Street Hospital, London, and colleagues.

PIMS-TS, also known as multisystem inflammatory syndrome in children (MIS-C), was first recognized in April 2020 and is now considered a distinct post-infectious, hyper-inflammatory syndrome.

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More than 250 cases of PIMS-TS were identified in the U.K. and Ireland from March to June 2020, with clinical features that included fever, rash, conjunctival infection and gastrointestinal symptoms, sometimes progressing to multi-organ failure requiring intensive care.

“Although the acute phase of PIMS-TS has been characterized, the short-term, medium-term, and long-term sequelae remain unclear. Similarly, little is known about rehabilitation requirements after discharge from hospital,” Dr. Moshal and colleagues note.

To investigate, they monitored 46 children (mean age: 10.2 years) treated at Great Ormond Street Hospital for PIMS-TS. Most were boys (65%) and from an ethnic-minority group (80%); only 17% had pre-existing comorbid conditions.

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At hospital admission, markers of systemic inflammation were elevated in all children. None of them died.

By six months, systemic inflammation had resolved in all but one child; 38 (90%) of 42 children who had positive SARS-CoV-2 IgG antibodies within six weeks of admission remained seropositive at six months.

Echocardiograms were normal in 44 (96%) of 46 children by six months.

GI symptoms that were reported in 45 (98%) children at PIMS-TS onset were still present in six (13%) children at six months.

Renal, hematological and otolaryngological findings largely resolved by the six-month mark.

Although minor abnormalities were identified on neurological examination in 24 (52%) patients at six weeks and in 18 (39%) at six months, the children had “minimal” functional impairment at six months (median Expanded Disability Status Scale score: 0).

Median manual muscle test-8 scores improved from 53 during hospital admission to 80 at six months, but 18 (45%) of 40 children showed six-minute walk test results below the third centile for their age or sex at six months.

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Filed Under: Conditions Tagged With: Children, COVID-19, Multisystem Inflammatory Syndrome in Children (MIS-C), Pediatric, pediatric inflammatory multisystem syndrome temporally associated with COVID-19 disease (PIMS-TS)

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