“Pediatric inflammatory multisystem syndrome”—Experiences from a Berlin Children’s Hospital

Abstract

Background: Since the beginning of the SARS-CoV‑2 pandemic, cases of the hyperinflammatory syndrome pediatric inflammatory multisystem syndrome (PIMS) have been accumulating. The clinical presentation is variable and it occurs 2–6 weeks after infection with SARS-CoV‑2. As of today, immunoglobulins and/or steroids as well as ASS are used for medication. Method: In our clinic 11 patients presented with PIMS between 06/2020 and 06/2021, whose data were retrospectively collected and analyzed. Results: Of the 11 patients 6 were male, the age distribution ranged from 4–18 years and 7 were overweight or obese. Almost all patients showed gastrointestinal and cardiovascular involvement, 4 had respiratory symptoms, 6 showed signs of nephritis. All showed blood count changes with anemia or leukocytosis and coagulopathy. CRP, ferritin, and soluble IL2 receptor were highly elevated in all patients. Only 2 patients had neither troponin‑T nor NT-pro-BNP elevation and 7 patients had impaired left ventricular function. Positive SARS-CoV‑2 serology was found in 10, and positive SARS-CoV‑2 PCR via nasopharyngeal swabs in 2. All were initially treated with antibiotics, 3 patients required O2 supplementation, 6 required intensive care and 5 required vasoactive agents. All but one patient received immunoglobulins and ASS, 5 received prednisolone. Length of stay ranged from 4–51 days. Conclusion: PIMS is a severe acute hyperinflammatory disease, which was secured in 11 patients in our clinic. In some cases, there was a need for intensive care. Under anti-inflammatory therapy there was a good response without exception.