Paediatric Inflammatory Multisystem Syndrome (PIMS) in the COVID-19 Pandemic

Abstract

Following a SARS-CoV-2 infection, usually mild, a small proportion of children develop multisystemic hyperinflammation (paediatric inflammatory multisystem syndrome (PIMS)) within approximately 6-8 weeks. Clinically, these patients present with signs of Kawasaki syndrome or toxic shock syndrome. The cardiac manifestation, in particular, with a marked limitation of cardiac function, requires intensive medical treatment in many individuals. The pathophysiology is still unclear although tremendous knowledge has been gained over the past one and a half years. A key role may be played by superantigens which, by binding to a specific β-chain of T-cell receptors, lead to polyclonal stimulation of T cells. In addition to intensive care management, intravenous immunoglobulins, steroids, and biologics are used to control inflammation.