June 8, 2020

expert reaction to new paper looking at clinical characteristics of 58 children in England hospitals with Kawasaki-like syndrome

A study, published in JAMA, looked at clinical characteristics of 58 children in England hospitals with Kawasaki-like syndrome.

Prof Adilia Warris, Paediatric Infectious Diseases Specialist and Co-director of the MRC Centre for Medical Mycology, University of Exeter, and Consultant at Great Ormond Street Hospital London, said:

“The study describes in great details the new inflammatory syndrome as observed in children during the course of the COIVD-19 pandemic in the UK. As the authors state very clearly in there paper, it is not sure at the moment that this syndrome is caused by COVID-19. It is tempting to draw an association between the two, but more data is needed to do so. The findings are of clinical importance as the authors have compared this new syndrome with other known comparable inflammatory syndromes in childhood, which is a first step to help us to understand this syndrome better. Their results suggest that PIMS is clinically different from the known inflammatory syndromes. What is important is to realize is that also for other inflammatory syndromes in childhood (e.g. Kawasaki disease), the cause is not known.

“PIMS is a rare disease and needs to be recognized early to initiate appropriate management. Outcome is favourable as presented in this well performed study.”

Dr Sanjay Patel, Consultant in Paediatric Infectious Diseases, Southampton Children’s Hospital, said:

Does this mean we can be sure this syndrome is caused by COVID-19 in these children or is it too early to know?

“Data is highly suggestive of a causal association between this inflammatory condition and COVID. 83% of the children who had serology tested were positive.

Are these findings robust; what do they tell us?

“These are robust findings – they tell us about the children with severe disease. They tell us that only a small proportion have coronary artery involvement (and only 3% with giant coronary artery aneurysms). The BAME findings (79% of the cohort) is similar to the French data – but this study doesn’t tell us why this observation is occurring (i.e. environmental or genetic or both).

Should parents be worried?

“It is rare – this paper describes 58 patients with PIMS-TS in the UK. This is a very small number of children (out of the >12 million children in the UK).

Is it good news most children have recovered?

“It is extremely reassuring that most children have recovered. Only one death in this cohort and excellent outcomes in children with severe PIMS-TS who are treated with immunomodulatory therapy (IVIg +- steroids +- monoclonal therapy).”

‘Clinical characteristics of 58 children with a pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2’ by Elizabeth Whittaker et al. was published in JAMA on Monday 8 June 2020.

DOI: 10.1001/jama.2020.10369

All our previous output on this subject can be seen at this weblink:

www.sciencemediacentre.org/tag/covid-19

Declared interests

None received.