COVID-19 is a disease about which we are likely to learn many more interesting and sometimes frightening things in the future. Some information on this entity is already available: COVID-19 was initially thought to be completely harmless in children, but it is now known that the disease can lead to a serious problem in the youngest children, namely PIMS-TS pocovid syndrome.
Table of contents:
- Causes of pocovid syndrome in children
- Symptoms of pocovid syndrome in children
- Diagnosis of pocovid syndrome in children
- Treatment of pocovid syndrome in children
- Prognosis of children with pocovid syndrome
Much research attention has been directed towards the course of COVID-19 in children. Initially - due to the fact that most coronavirus infections ran a sparse or even asymptomatic course in children - it was thought that the disease was not particularly dangerous for the youngest patients. However, for some time now, some children have been experiencing worrying and atypical symptoms. It turned out that the PIMS-TS syndrome (an acronym for paediatric inflammatory multisystem syndrome - temporally associated with SARS-CoV-2), sometimes also referred to as paediatric pocovid syndrome, was responsible for their occurrence.
Causes of pocovid syndrome in children
What is not really clear is why some children develop PIMS-TS syndrome after COVID-19. Researchers have been able to find out that the problem occurs in patients who have undergone the infection both completely asymptomatic and in those who have nevertheless developed some kind of complaints. The occurrence of pocovid syndrome during the recovery period was also observed.
It is suspected that pocovid syndrome in children may occur due to an excessive immune system response. In such a situation, even systemic inflammation may develop, the symptoms of which may be very serious.
Symptoms of pocovid syndrome in children
Typically, the illness begins with a high fever that lasts for about three days. In addition, among the possible symptoms of pocovid syndrome in children described so far are:
- diarrhoea
- vomiting,
- raspberry tongue,
- rash,
- redness of the conjunctiva,
- significant weakness,
- abdominal pain of unclear cause,
- enlarged lymph nodes,
- swelling of the hands and feet,
- hypotension,
- seizures,
- decreased urination or even anuria.
Pocovid syndrome in children, photo: panthermedia
Diagnosis of pocovid syndrome in children
Making a diagnosis of PIMS-TS is usually not easy - not least because COVID-19 is completely asymptomatic in most children. However, the WHO has developed preliminary criteria for the diagnosis of pocovid syndrome in children. Among these are:
- the presence of fever in the patient along with at least some of the complaints mentioned above,
- the presence of elevated levels of inflammatory markers in laboratory tests (such as CRP or procalcitonin),
- a previously positive RT-PCR result for SARS-CoV-2 or a high probability of contact of the child with a COVID-19 infected person. Before diagnosing pocovida syndrome in a child, it is important to exclude other possible causes of the child's complaints, especially sepsis.
In general, therefore, a number of different tests are necessary before a specific diagnosis can be made. These include laboratory tests (determination of inflammatory markers, blood count, creatinine, liver enzymes and others), imaging tests (such as echocardiography or medical ultrasound of the abdomen). Accurate diagnosis is important for a number of different reasons - as an example, it has been reported that some children with pocovid syndrome who had increased abdominal pain had appendicitis initially suspected and thus surgery performed.
Treatment of pocovid syndrome in children
A child with suspected PIMS-TS should definitely be admitted to hospital - the course of the condition can result in cardiac dysfunction (sometimes progressing to heart failure), but also kidney or liver dysfunction. The disease is treated with immunoglobulin infusions and sometimes steroid therapy.
Prognosis of children with pocovid syndrome
At the moment, it is difficult to say exactly what the prognosis is for PIMS-TS syndrome in children - the first case of this entity was described in April in the United States. Work to find the specific causes of this problem and how it should best be treated is still ongoing. Parents can already be advised to be vigilant and to seek help as soon as possible if their children develop any worrying symptoms. This is especially necessary if parents know that their child has had COVID-19 and if they know that their child has had contact with people who may be infected with the SARS-CoV-2 coronavirus.
