Nationwide observational study of paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) in the Czech Republic

Authors	DAVID Jan STARA Veronika HRADSKY Ondrej TUČKOVÁ Jana SLABÁ Kateřina JABANDŽIEV Petr SASEK Lumir HUML Michal ZIDKOVA Iveta PAVLICEK Jan PALATOVA Alzbeta KLASKOVA Eva BANSZKA Karina TERIFAJOVA Eva VYHNANEK Radim BLOOMFIELD Marketa FINGERHUTOVA Sarka DOLEZALOVA Pavla PROCHAZKOVA Lucie CHRAMOSTOVA Gabriela FENCL Filip LEBL Jan
Year of publication	2022
Type	Article in Periodical
Magazine / Source	European journal of pediatrics
MU Faculty or unit	Faculty of Medicine
Citation
Web	https://link.springer.com/article/10.1007/s00431-022-04593-7
Doi	http://dx.doi.org/10.1007/s00431-022-04593-7
Keywords	MIS-C; COVID-19; Incidence; Predictors; Severe outcome; Myocardial dysfunction
Description	The worldwide outbreak of the novel 2019 coronavirus disease (COVID-19) has led to recognition of a new immunopathological condition: paediatric inflammatory multisystem syndrome (PIMS-TS). The Czech Republic (CZ) suffered from one of the highest incidences of individuals who tested positive during pandemic waves. The aim of this study was to analyse epidemiological, clinical, and laboratory characteristics of all cases of paediatric inflammatory multisystem syndrome (PIMS-TS) in the Czech Republic (CZ) and their predictors of severe course. We performed a retrospective-prospective nationwide observational study based on patients hospitalised with PIMS-TS in CZ between 1 November 2020 and 31 May 2021. The anonymised data of patients were abstracted from medical record review. Using the inclusion criteria according to World Health Organization definition, 207 patients with PIMS-TS were enrolled in this study. The incidence of PIMS-TS out of all SARS-CoV-2-positive children was 0.9:1,000. The estimated delay between the occurrence of PIMS-TS and the COVID-19 pandemic wave was 3 weeks. The significant initial predictors of myocardial dysfunction included mainly cardiovascular signs (hypotension, oedema, oliguria/anuria, and prolonged capillary refill). During follow-up, most patients (98.8%) had normal cardiac function, with no residual findings. No fatal cases were reported. Conclusions: A 3-week interval in combination with incidence of COVID-19 could help increase pre-test probability of PIMS-TS during pandemic waves in the suspected cases. Although the parameters of the models do not allow one to completely divide patients into high and low risk groups, knowing the most important predictors surely could help clinical management.