According to ECDC, several countries affected by the COVID-19 pandemic recently reported cases of children that were hospitalised in intensive care due to a rare paediatric inflammatory multisystem syndrome (PIMS). The presenting signs and symptoms are a mix of the ones for Kawasaki disease (KD) and toxic shock syndrome (TSS) and are characterised, among others, by fever, abdominal pain and cardiac involvement. A possible temporal association with SARS-COV-2 infection has been hypothesised because some of the children that were tested for SARS-CoV-2 infection were either positive by polymerase chain reaction (PCR) or serology.
The ECDC noted that about 230 suspected cases of this new paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 infection (PIMS-TS) have been reported in EU/EEA countries and the UK in 2020, including two fatalities- one in the UK and one in France. These cases are being further investigated.
“So far, epidemiological studies have shown that children appear to be less affected by COVID-19. Only 2.1% of all laboratory-confirmed COVID-19 cases reported to The European Surveillance System (TESSy) were in the age group between 0 and 14 years of age”, the agency stated.
The ECDC also added that an association between SARS-CoV-2 infection and this new clinical entity of multisystem inflammation has not yet been established to date, although an association appears plausible. The ECDC assessed the risks as follows:
The overall risk of COVID-19 in children in the EU/EEA and UK is currently considered low, based on a low probability of COVID-19 in children and a moderate impact of such disease.
The overall risk of PIMS-TS in children in the EU/EEA and the UK – is considered low, based on a very low probability of PIMS-TS in children and a high impact of such disease.
“While the clinical management of these children has absolute priority, data collection from EU/EEA Member States and the UK would strengthen the body of knowledge for this rare condition and allow for a better analysis of these cases. An analysis of surveillance data could clarify the incidence of KD/PIMS and identify the most affected age groups and risk factors for both conditions”, the ECDC noted.
ECDC has agreed with the EU/EAA Member States and the UK to include PIMS as a possible complication to be reported for EU-level COVID-19 surveillance. According to the agency, research efforts should aim at determining the role of SARS-CoV-2 in the pathogenesis of PIMS-TS and answering other significant remaining questions.