Table of contents:

What is PIMS?
Symptoms of PIMS
Course of the disease
Investigations
Treatment

The coronavirus pandemic has changed everything around us. The world has been turned on its head - we have begun an unequal battle against an invisible enemy. Despite the advent of vaccination and the entry of medicines, coronavirus remains dangerous - also for the youngest. Researchers' studies show that children are less likely to be infected with COVID-19 than adults, but this does not mean that they do not get sick. Children can become ill - full-blown, sparsely symptomatic or even asymptomatic. Even in asymptomatic children, PIMS can develop within two to four weeks, leading to very severe complications in extreme cases.

What is PIMS?

PIMS is a so-called paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2, which is a complication of coronavirus transmission. At present, it is known that children are the most commonly affected, with a median age of nine years. However, this does not mean that older children do not become ill. The first cases of PIMS were reported in Poland in May 2020. As the disease progresses very quickly, it is important to keep a close eye on your child and contact your doctor immediately if there are any worrying symptoms.

Symptoms of PIMS

The most common paediatric symptoms in the so-called PIMS multisystem inflammatory syndrome are:

Fever
Headache
Sore throat
Cough
Gastrointestinal problems (abdominal pain, diarrhoea, vomiting)
Conjunctivitis (congestion of the whites of the eyes, without discharge)
Red, chapped lips
Changes on the tongue - "vivid red colour", small pustules on the tongue (appearance of the surface of a strawberry)
Swelling of the hands and feet
Weakness
Rash in various parts of the body (pink patches, may take the shape of rings)
Dysfunction of the heart muscle
Hypotension
Enlargement of the lymph nodes

Symptoms do not have to occur together!

Course of disease

The course of the disease varies from mild to very severe. At the beginning of the disease, mainly gastrointestinal disorders resembling appendicitis are observed. Severe abdominal pain, apathy, excessive sleepiness and unusual behaviour may occur. As the disease progresses, shortness of breath and chest pains, fainting, less urination occur. Shock and multiple organ failure can occur!!!

Research

Unfortunately, at the moment there is no conclusive test that directly detects PIMS. However, PIMS is known to give characteristic abnormalities in laboratory tests, among others:

Significant elevation of inflammatory markers
Decreased lymphocyte count on morphology
Ion abnormalities
Protein abnormalities
Elevation of markers of cardiac damage

It is therefore worthwhile performing tests such as:

Blood morphology
Fibrinogen
D-dimers
Markers of inflammation (ESR., CRP, etc.)
SARS-Cov-2 antibodies
Sodium and potassium concentrations
Triglycerides
Amylase, lipase, ASAT, ALT, GGT, albumin, bilirubin

Treatment

The treatment of PIMS takes place in a hospital setting, as the child's condition can deteriorate rapidly. In addition, due to the risk of complications such as coronary heart aneurysms, the child must be under observation. Treatment is based on the administration of immunoglobulins, intravenous corticosteroids and biologic drugs (tocilizumab, infliximab, anakinra). Importantly, following PIMS, it is recommended that the child is under medical care for at least the next six weeks.

Remember - do not underestimate any symptoms. If there is anything that concerns you about your child's condition - consult your paediatrician urgently.

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