Shining a light on PIMS-TS
( Paediatric Multi-inflammatory Syndrome temporally associated with SARS-CoV-2 )
What is PIMS-TS?
PIMS stands for Paediatric Multisystem Inflammatory Syndrome
TS stands for temporally associated with SARS-CoV-2, which means that it is linked to and follows on from contact (infection) with COVID.
In the USA and elsewhere PIMS is known as MIS-C or Multisystem Inflammatory Syndrome in Children. There is also a classification for MIS-A, which is seen in adults, but is much less common, and more recently MIS-N for neonates (infants up to 4 weeks old).

An INFLAMMATORY SYNDROME is not infectious and not a disease, it is an overreaction of the body’s immune system (an autoinflammatory response) which can be TRIGGERED BY INFECTIONS, VIRUSES etc. This process is sometimes referred to as a CYTOKINE STORM.

PROLONGED HIGH TEMPERATURES are a sign of this acute inflammation and can result in dangerous changes to vessels and organs including the heart.  The body can also develop SHOCK SYNDROME, causing low blood pressure and high pulse rate and this can quickly become life threatening and require urgent PAEDIACTRIC ICU treatment.
PIMS-TS was identified as a new entity around May 2020, although it was in evidence for several months before.
It is now widely accepted that the trigger for PIMS-TS is SARS-CoV-2 and that it occurs in some children between 2-6 WEEKS AFTER COVID and most often after 4 weeks after infection with COVID.

PIMS-TS was originally referred to as being like KAWASAKI DISEASE/SYNDROME, which is also an autoinflammatory syndrome and shares most of its symptoms. This has helped with the treatment of PIMS, as medics have drawn on treatments used for Kawasaki disease to treat PIMS-TS.
PIMS hashtag infographic
Kawasaki Disease also known as KD was identified 60 years ago, but a cause or trigger has yet to be established. KD is thought to involve a genetic predisposition and is more common in children of East Asian/Japanese descent. It is also more common in boys (1.5) than girls (1.0). The age range is generally 1-5, with a median age of 2, but does also appear in older children.

Case data analysis of PIMS-TS so far, shows very similar results: with
MORE BOYS THAN GIRLS (1.5 boys 1.0 girls). It is more common in children of AFRICAN, AFRO-CARIBBEAN, AND HISPANIC descent. The age range is GENERALLY 1 to 16 YEARS With a median age of 7.

In children, COVID itself can often be ASYMPTOMATIC and therefore PIMS-TS can come out the blue, be quite frightening and need URGENT MEDICAL ATTENTION. Children will generally NOT TEST POSITIVE TO COVID when unwell with PIMS-TS and MAY OR MAY NOT TEST POSITIVE TO COVID ANTIBODIES
Like KD, PIMS-TS needs to be diagnosed and treated promptly to ensure best outcomes. Its SYMPTOMS ARE MULTIPLE AND MIMIC OTHER CONDITIONS, making diagnosis challenging.
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