Pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 infection
https://doi.org/10.47183/mes.2021.017
Abstract
Despite the low incidence, low mortality and relatively mild symptoms of COVID-19 in children, there has been a rise in pediatric patients who develop a condition resembling Kawasaki disease after COVID-19 or contact with individuals infected with SARS-CoV-2. This condition is known as the pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 infection (PIMS-TS). This review introduces the reader to the hypotheses of PIMS-TS pathogenesis, provides information about its diagnosis and treatment, presents clinical and laboratory data and describes treatments strategies used in children and adolescents hospitalized to the intensive care unit of the Pediatric Research and Clinical Center for Infectious Diseases. Besides, the review outlines the main diagnostic and prognostic challenges of PIMS-TS.
About the Authors
Yu. V. Lobzin
Pediatric Research and Clinical Center for Infectious Diseases of FMBA; Mechnikov North-West State Medical University; Kirov Military Medical Academy
Russian Federation
Russian Federation
Saint Petersburg
A. N. Uskov
Pediatric Research and Clinical Center for Infectious Diseases of FMBA
Russian Federation
Russian Federation
Saint Petersburg
N. V. Skripchenko
Pediatric Research and Clinical Center for Infectious Diseases of FMBA; Saint Petersburg State Pediatric Medical University
Russian Federation
Russian Federation
Saint Petersburg
A. A. Vilnits
Pediatric Research and Clinical Center for Infectious Diseases of FMBA; Saint Petersburg State Pediatric Medical University
Russian Federation
Russian Federation
Alla A. Vilnits
Professora Popova, 9, Saint Petersburg, 197022
M. K. Bekhtereva
Pediatric Research and Clinical Center for Infectious Diseases of FMBA; Saint Petersburg State Pediatric Medical University
Russian Federation
Russian Federation
Saint Petersburg
I. V. Babachenko
Pediatric Research and Clinical Center for Infectious Diseases of FMBA; Saint Petersburg State Pediatric Medical University
Russian Federation
Russian Federation
Saint Petersburg
References
1. WHO Coronavirus (COVID-19) Dashboard. 2021 Apr (cited 2021 Apr 07). Available from: https://covid19.who.int/ .
2. Ludvigsson J.F. Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults. Acta Paediatr 2020; 109: 1088–95. PMID: 32202343 DOI: 10.1111/apa.15270.
3. Ding Y., Yan H., Guo W. Clinical Characteristics of Children with COVID-19: A Meta-Analysis. Front Pediatr 2020; 8: 431. PMID: 32719759 DOI: 10.3389/fped.2020.00431.
4. Guo C.X., He L., Yin J.Y., Meng X.G., Tan W., Yang G.P., et al. Epidemiological and clinical features of pediatric COVID-19. BMC Med 2020; 18: 250. PMID: 32762696 DOI:10.1186/s12916-020-01719-2.
5. Усков А.Н., Лобзин Ю.В., Рычкова С.В., Бабаченко И.В., Федоров В.В., Улуханова Л.У. и др. Течение новой коронавирусной инфекции у детей: некоторые аспекты мониторинга заболеваемости и анализа летальности. Журнал инфектологии. 2020; 12 (3): 12–20. DOI: 10.22625/2072-6732-2020-12-3-12-20.
6. Leidman E., Duca L.M., Omura J.D., Proia K., Stephens J.W., Sauber-Schatz E.K. COVID-19 Trends Among Persons Aged 0—24 Years — United States, March 1-December 12, 2020. MMWR Morb Mortal Wkly Rep. 2021; 70 (3): 88–94. DOI: 10.15585/mmwr.mm7003e1. PMID: 33476314; PMCID: PMC7821770.
7. Jones V.G., Mills M., Suarez D., Hogan C.A., Yeh D., Segal J.B., et al. COVID-19 and Kawasaki Disease: Novel Virus and Novel Case. Hosp Pediatr. 2020; 10 (6): 537–40. DOI: 10.1542/hpeds.2020-0123. Epub 2020 Apr 7. PMID: 32265235.
8. Davies P., Evans C., Kanthimathinathan H.K., Lillie J., Brierley J., Waters G., et al. Intensive care admissions of children with paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) in the UK: a multicentre observational study. Lancet Child Adolesc Health. 2020; 4 (9): 669–77. DOI: 10.1016/S2352-4642(20)30215-7. PMID: 32653054; PMCID: PMC7347350.
9. Verdoni L., Mazza A., Gervasoni A., Martelli L., Ruggeri M., Ciuffreda M., et al. An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study. Lancet. 2020; 395 (10239): 1771–8. DOI: 10.1016/S0140-6736(20)31103-X. PMID: 32410760; PMCID: PMC7220177.
10. Rowley A.H. Understanding SARS-CoV-2-related multisystem inflammatory syndrome in children. Nat Rev Immunol. 2020; 20 (8): 453–4. DOI: 10.1038/s41577-020-0367-5. PMID: 32546853; PMCID: PMC7296515.
11. Evans C., Davies P. SARS-CoV-2 paediatric inflammatory syndrome. Paediatr Child Health (Oxford). 2021; 31 (3): 110–5. DOI: 10.1016/j.paed.2020.12.003. PMID: 33391390; PMCID: PMC7762804.
12. Dolhnikoff M., Ferreira Ferranti J., de Almeida Monteiro R.A., Duarte-Neto A.N., Soares Gomes-Gouvêa M., Viu Degaspare N., et al. SARS-CoV-2 in cardiac tissue of a child with COVID-19-related multisystem inflammatory syndrome. Lancet Child Adolesc Health. 2020; 4 (10): 790–4. DOI: 10.1016/S2352-4642(20)30257-1. PMID: 32828177; PMCID: PMC7440866.
13. Брегель Л.В., Костик М.М., Фелль Л.З., Ефремова О.С., Соболева М.К., Крупская Т.С. и др. Болезнь Кавасаки и мультисистемный воспалительный синдром при инфекции COVID-19 у детей. Педиатрия им. Г. Н. Сперанского. 2020; 99 (6): 209–19. DOI: 10.24110/0031-403X-2020-99-6-209-219.
14. Ravelli A., Minoia F., Davì S., Horne A., Bovis F., Pistorio A., et al. 2016 Classification Criteria for Macrophage Activation Syndrome Complicating Systemic Juvenile Idiopathic Arthritis: A European League Against Rheumatism/American College of Rheumatology/ Paediatric Rheumatology International Trials Organisation Collaborative Initiative. Ann Rheum Dis. 2016;75(3):481–9. DOI: 10.1136/annrheumdis-2015-208982. PMID: 26865703.
15. Toubiana J., Poirault C., Corsia A., Bajolle F., Fourgeaud J., Angoulvant F., et al. Kawasaki-like multisystem inflammatory syndrome in children during the covid-19 pandemic in Paris, France: prospective observational study. BMJ. 2020; 369: m2094. DOI: 10.1136/bmj.m2094. PMID: 32493739; PMCID: PMC7500538.
16. Consiglio C., Cotugno N., Sardh F., et al. The immunology of multisystem inflammatory syndrome in children with COVID-19. 2020; 12; 183 (4): 968–81.e7. DOI: 10.1016/j.cell.2020.09.016. PMID: 32966765; PMCID: PMC7474869.
17. Gruber C.N., Patel R.S., Trachtman R., Lepow L., Amanat F., Krammer F., et al. Mapping Systemic Inflammation and Antibody Responses in Multisystem Inflammatory Syndrome in Children (MIS-C). Cell. 2020; 183 (4): 982–95.e14. DOI: 10.1016/j.cell.2020.09.034. PMID: 32991843; PMCID: PMC7489877.
18. Hoste L., Van Paemel R., Haerynck F.. Multisystem inflammatory syndrome in children related to COVID-19: a systematic review. Eur J Pediatr. 2021; 18: 1–16. DOI: 10.1007/s00431-021-03993-5. PMID: 33599835; PMCID: PMC7890544.
19. Yasuhara J., Watanabe K., Takagi H., Sumitomo N., Kuno T. COVID-19 and multisystem inflammatory syndrome in children: A systematic review and meta-analysis. Pediatr Pulmonol. 2021; 11: 10.1002/ppul.25245. DOI: 10.1002/ppul.25245. PMID: 33428826; PMCID: PMC801339.
20. Tang Y., Li W., Baskota M., Zhou Q., Fu Z., Luo Z., et al. Multisystem inflammatory syndrome in children during the coronavirus disease 2019 (COVID-19) pandemic: a systematic review of published case studies. Transl Pediatr. 2021; 10 (1): 121–35. DOI: 10.21037/tp-20-188. PMID: 33633944; PMCID: PMC7882293.
21. Daskalakis D. Health Alert# 13: pediatric multi-system inflammatory syndrome potentially associated with COVID-19 // NYC Health [Internet]. 2020 May [cited 2021 Apr 07]. Available from: https://www1.nyc.gov/assets/doh/downloads/pdf/han/alert/2020/covid-19-pediatric-multi-system-inflammatorysyndrome.pdf.
22. Ahmed M., Advani S., Moreira A., Zoretic S., Martinez J., Chorath K., et al. Multisystem inflammatory syndrome in children: A systematic review. EClinicalMedicine. 2020; 26: 100527. DOI: 10.1016/j.eclinm.2020.100527. PMID: 32923992; PMCID: PMC7473262.
23. Jindal A.K., Pilania R.K., Prithvi A., Guleria S., Singh S. Kawasaki disease: characteristics, diagnosis, and unusual presentations. Expert Rev Clin Immunol. 2019; 15 (10): 1089–104. DOI: 10.1080/1744666X.2019.1659726. PMID: 31456443.
24. Whittaker E., Bamford A., Kenny J., Kaforou M., Jones C.E., Shah P., et al. PIMS-TS Study Group and EUCLIDS and PERFORM Consortia. Clinical Characteristics of 58 Children With a Pediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2. JAMA. 2020; 324 (3): 259–69. DOI: 10.1001/jama.2020.10369. PMID: 32511692; PMCID: PMC7281356.
25. Wu L., O'Kane A.M., Peng H., Bi Y., Motriuk-Smith D., Ren J. SARS-CoV-2 and cardiovascular complications: From molecular mechanisms to pharmaceutical management. Biochem Pharmacol. 2020; 178: 114114. DOI: 10.1016/j.bcp.2020.114114. PMID: 32579957; PMCID: PMC7306106.
26. Royal College of Paediatric and Child Health. Guidance: paediatric multisystem inflammatory syndrome temporally associated with COVID-19. 2020 May 01 (cited 2021 Apr 07). Available from: https://www.rcpch.ac.uk/resources/guidance-paediatricmultisystem-inflammatory-syndrome-temporally-associatedcovid-19.
27. Cuomo A.M., Zucker H.A., Dreslin S. Health advisory: pediatric multi-system inflammatory syndrome potentially associated with сoronavirus disease (COVID-19) children // New York State of Opportunity. Department of Health. 2020 May 06 (cited 2021 Jan 24). Available from: https://www.health.ny.gov/press/releases/2020/docs/2020-05-06_covid19_pediatric_inflammatory_syndrome.pdf.
28. Лобзин Ю.В., Вильниц А.А., Костик М.М. и др. Педиатрический мультисистемный воспалительный синдром, ассоциированный с новой коронавирусной инфекцией: нерешенные проблемы. Журнал инфектологии. 2021; 13 (1): 13–20. https://doi.org/10.22625/2072-6732-2021-13-1-13-20.
29. Kawasaki T. Kawasaki disease. Proc Jpn Acad Ser B Phys Biol Sci. 2006; 82 (2): 59–71. DOI: 10.2183/pjab.82.59. PMID: 25792773; PMCID: PMC4323050. 30. Kawasaki T. Kawasaki disease. Int J Rheum Dis. 2014; 17 (5): 597–600. DOI: 10.1111/1756-185X.12408.
30. Александрович Ю.С., Алексеева Е.И., Бакрадзе М.Д. и др. Особенности клинических проявлений и лечения заболевания, вызванного новой коронавирусной инфекцией (COVID-19), у детей. Методические рекомендации. Версия 2. Педиатрическая фармакология. 2020; 17 (3): 187–212. DOI: 10.15690/pf.v17i3.2123.
Review
For citations:
Lobzin Yu.V., Uskov A.N., Skripchenko N.V., Vilnits A.A., Bekhtereva M.K., Babachenko I.V. Pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 infection. . 2021;23(2):13-19. https://doi.org/10.47183/mes.2021.017
