Abstract
Background: Paediatric Multisystem Inflammatory Syndrome temporally associated with SARS-CoV-2 (PIMS-TS), first identified in April 2020, shares features of both Kawasaki disease (KD) and toxic shock syndrome (TSS). The surveillance describes the epidemiology and clinical characteristics of PIMS-TS in the United Kingdom and Ireland.
Methods: Public Health England initiated prospective national surveillance of PIMS-TS through the British Paediatric Surveillance Unit. Paediatricians were contacted monthly to report PIMS-TS, KD and TSS cases electronically and complete a detailed clinical questionnaire. Cases with symptom onset between 01 March and 15 June 2020 were included.
Findings: There were 216 cases with features of PIMS-TS alone, 13 with features of both PIMS-TS and KD, 28 with features of PIMS-TS and TSS and 11 with features of PIMS-TS, KD and TSS, with differences in age, ethnicity, clinical presentation and disease severity between the phenotypic groups. There was a strong geographical and temporal association between SARS-CoV-2 infection rates and PIMS-TS cases. Of those tested, 14.8% (39/264) children had a positive SARS-CoV-2 RT-PCR, and 63.6% (75/118) were positive for SARS-CoV-2 antibodies. In total 44·0% (118/268) required intensive care, which was more common in cases with a TSS phenotype. Three of five children with cardiac arrest had TSS phenotype. Three children (1·1%) died.
Interpretation: The strong association between SARS-CoV-2 infection and PIMS-TS emphasises the importance of maintaining low community infection rates to reduce the risk of this rare but severe complication in children and adolescents. Close follow-up will be important to monitor long-term complications in children with PIMS-TS.
Funding: PHE.
| Original language | English |
|---|---|
| Article number | 100075 |
| Number of pages | 11 |
| Journal | The Lancet Regional Health - Europe |
| Volume | 3 |
| Early online date | 22 Mar 2021 |
| DOIs | |
| Publication status | Published - Apr 2021 |
Bibliographical note
Funding Information: This surveillance was internally funded by PHE and did not receive any specific grant funding from agencies in the public, commercial or not-for-profit sectors.Prof. Semple reports grants from DHSC National Institute of Health Research UK, grants from Medical Research Council UK, grants from Health Protection Research Unit in Emerging & Zoonotic Infections, University of Liverpool, during the conduct of the study; other from Integrum Scientific LLC, Greensboro, NC, USA, outside the submitted work. Dr. Ramanan reports personal fees from EliLilly, personal fees from Roche, personal fees from SOBI, personal fees from UCB, personal fees from Abbvie, personal fees from Novartis, outside the submitted work.
Open Access: This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Publisher Copyright: Crown Copyright © 2021 Published by Elsevier Ltd
Citation: Jessica Flood, Joseph Shingleton, Emma Bennett, Brodie Walker, Zahin Amin-Chowdhury, Godwin Oligbu, Jacob Avis, Richard M. Lynn, Peter Davis, Tara Bharucha, Clare E Pain, Deepthi Jyothish, Elizabeth Whittaker, Buvana Dwarakanathan, Rachael Wood, Christopher Williams, Olivia Swann, Malcolm G Semple, Mary E Ramsay, Christine E Jones, Athimalaipet V Ramanan, Nick Gent, Shamez N Ladhani, Paediatric multisystem inflammatory syndrome temporally associated with SARS-CoV-2 (PIMS-TS): Prospective, national surveillance, United Kingdom and Ireland, 2020, The Lancet Regional Health - Europe, Volume 3, 2021, 100075, ISSN 2666-7762,
DOI: https://doi.org/10.1016/j.lanepe.2021.100075.
