Article Text
PDF
Abstract
Aims The COVID-19 pandemic has presented new challenges. Fortunately the paediatric age group has been less affected by COVID-19 itself but there has been an emergence of a new entity: Paediatric Multisystem Inflammatory Syndrome temporally associated with SARS-CoV-2 (PIMS-TS). Evidence for short-term outcomes of PIMS-TS has been promising, but there is a lack of follow-up studies. Information from adult studies has emerged regarding symptoms of long COVID and post-COVID postural orthostatic tachycardia syndrome (POTS). Here we explored the temporal progression of long-term symptoms following PIMS-TS using a parent-reported questionnaire.
Methods Children with a confirmed diagnosis of PIMS-TS on our unit at the time of diagnosis were identified. Case records and discharge summaries were reviewed to understand the severity of initial symptoA tele-questionnaire was developed focussing on questions related to POTS, general symptoms, and life activities. Parents were verbally consented and asked about symptoms 3 and 6 months after the illness. No children had pre-existing symptoms.
Results The study population (n=20, F:M=11:9) had a mean age of 9 years (2 – 16 years). 80% were >6 years of age. Need for intensive care was identified in 60% with 45% needing ionotropic support. 80% were treated with steroids while 45% had intravenous immunoglobulin.
20% reported symptoms of POTS at 3 months after illness (figure 1). Common symptoms were brain fogging and dizziness followed by postural symptoms and blurred vision. 15% had ongoing brain fogging and dizziness at 6 months.
Myalgia (35%), headache (30%), mood changes (20%), sleep problems (20%) and peripheral vascular changes (10%) were reported at 3 months. All symptoms were improving but did not fully recover.
3 months after PIMS-TS parents reported difficulties with physical activities including walking and running (30%), sports (25%), school attendance and peer interaction (20%) and need for mental health support (10%). This also improved after 6 months.
Conclusion PIMS-TS is a serious condition and can make children and young people critically unwell needing intensive care. Short-term follow up and recovery of biochemical parameters has been discussed in studies from the UK and USA.1,2 Our study is the first of its kind using a tele-consultation model for data collection. This is a retrospective single-centre study from a busy university level hospital. Our study highlights that up to 35% of our patients have physical and life activity related symptoms at 3 months with improvement by 6 months after PIMS-TS.
We recommend that patients recovering from PIMS-TS should be followed up so that recovery back to baseline can be established. They may need ongoing support and rehabilitation.
Disclosure Authors acknowledge that is study population is small, but this also depicts the infrequent nature of PIMS-TS.