Presentation, Treatment Response and Short-Term Outcomes in Paediatric Multisystem Inflammatory Syndrome Temporally Associated with SARS-CoV-2 (PIMS-TS)
Abstract
:1. Introduction
2. Patients and Methods
3. Results and Discussion
3.1. Epidemiology and Demographics
3.2. Laboratory Evidence of SARS-CoV-2
3.3. Clinical Presentation on Admission
3.4. Laboratory Findings
3.5. Imaging Abnormalities
3.6. Classification of Systemic Inflammation
3.7. Cardiovascular Involvement
3.8. Treatment and Early Treatment Response
3.9. Outcomes and Short-Term Prognosis
4. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Parameter | All (Median; IQR) | <5 Years; n = 10 | ≥5 Years; n = 17 | p |
---|---|---|---|---|
Haemoglobin (g/L) | 104.0 (93–115) | 105.0 (88.5–110) | 102 (93–125.5) | 0.47 |
White blood count (×109/L) | 9.7 (4.2–12.6) | 9.8 (4.3–18.8) | 9.6 (4.0–11.4) | 0.53 |
Neutrophils (×109/L) | 7.4 (3.0–10.0) | 7.5 (2.5–13.4) | 7.1 (3.5–9.2) | 0.58 |
Lymphocyte count (×109/L) | 1.1 (0.4–1.5) | 1.7 (0.8–3.9) | 0.54 (0.36–1.2) | 0.001 * |
Age-adjusted lymphocyte count (1.0 = 10th centile of age adjusted normal range) | 0.43 (0.25–0.62) | 0.52 (0.36–0.97) | 0.34 (0.2–0.57) | 0.04 * |
Platelet count (×106/L) | 207 (137–339) | 260 (145–375) | 223.8 (125.9) | 0.30 |
Features of Systemic Inflammation | n | % |
---|---|---|
RCPCH PIMS-TS criteria | 29 | 100 |
CDC MIS-C criteria | 21 | 72.4 |
Features of Kawasaki Disease | 19 | 65.5 |
Features of classic Kawasaki Disease | 11 | 37.9 |
Features of incomplete Kawasaki Disease | 8 | 27.6 |
Features of Macrophage activation syndrome MAS, H score | ||
≤95 | 16 | 61.5 |
≤130 | 8 | 30.8 |
≤150 | 1 | 3.8 |
≤220 | 1 | 3.8 |
missing | 3 | 10.3 |
Treatment Regimen Resulting in Symptom Resolution | n | % |
---|---|---|
1 dose IVIG | 4 | 13.8 |
2 doses IVIG | 1 | 3.4 |
2 doses IVIG followed by po Prednisolone taper | 1 | 3.4 |
1 dose IVIG comb MP followed by SPT | 6 | 20.7 |
2 doses IVIG comb MP followed by SPT | 3 | 10.3 |
IVIG, then IVIG comb MP followed by SPT | 9 | 31.0 |
1 dose IVIG followed by MP followed by SPT | 1 | 3.4 |
2 doses IVIG followed by MP followed by SPT | 1 | 3.4 |
IVIG followed by IVIG comb MP, then Anakinra, followed by SPT | 1 | 3.4 |
Anakinra | 1 | 3.4 |
IVIG, followed by IVIG comb MP followed by SPT, then Infliximab | 1 | 3.4 |
Total | 29 | 100.0 |
Clinical Complications Observed at 2 Weeks FU: | n |
---|---|
Reoccurrence of rash | 2 |
Occurrence of new vasculitic rash | 1 |
Edema of hands and feet | 1 |
Reoccurrence of palmar erythema | 1 |
Hepatomegaly (mild) | 1 |
Abdominal pain | 2 |
Proteinuria | 1 |
Subjective palpitations | 1 |
Junctional arrhythmia | 1 |
Bradycardia with bundle branch block | 1 |
Asymptomatic | 17 |
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Felsenstein, S.; Willis, E.; Lythgoe, H.; McCann, L.; Cleary, A.; Mahmood, K.; Porter, D.; Jones, J.; McDonagh, J.; Chieng, A.; et al. Presentation, Treatment Response and Short-Term Outcomes in Paediatric Multisystem Inflammatory Syndrome Temporally Associated with SARS-CoV-2 (PIMS-TS). J. Clin. Med. 2020, 9, 3293. https://doi.org/10.3390/jcm9103293
Felsenstein S, Willis E, Lythgoe H, McCann L, Cleary A, Mahmood K, Porter D, Jones J, McDonagh J, Chieng A, et al. Presentation, Treatment Response and Short-Term Outcomes in Paediatric Multisystem Inflammatory Syndrome Temporally Associated with SARS-CoV-2 (PIMS-TS). Journal of Clinical Medicine. 2020; 9(10):3293. https://doi.org/10.3390/jcm9103293
Chicago/Turabian StyleFelsenstein, Susanna, Emily Willis, Hannah Lythgoe, Liza McCann, Andrew Cleary, Kamran Mahmood, David Porter, Jessica Jones, Janet McDonagh, Alice Chieng, and et al. 2020. "Presentation, Treatment Response and Short-Term Outcomes in Paediatric Multisystem Inflammatory Syndrome Temporally Associated with SARS-CoV-2 (PIMS-TS)" Journal of Clinical Medicine 9, no. 10: 3293. https://doi.org/10.3390/jcm9103293