A UK study into critically ill children admitted to paediatric intensive care units with symptoms of a rare, new inflammatory syndrome, has combined data from units across the country to offer the first nationwide insights into the true extent of the condition.
Reports have emerged in recent weeks, during the COVID-19 pandemic, of children presenting with symptoms of a new condition similar to those seen in Kawasaki disease and Toxic Shock Syndrome. The new condition has been termed Paediatric Inflammatory Multi-System Syndrome - Temporally associated with SARS-CoV-2 (PIMS-TS), and affects older children. There have been reports of cases in the UK, across Europe, and the United States.
This latest study brings together data on 78 children, admitted to 15 intensive care units over a six week period between April and May 2020. Some of these cases have been previously reported in smaller studies, but this study brings together the largest number of cases in a cohort of children with this condition needing life support. Comparison with historical data shows an average of 11 fold increase (peaking at 26-fold) in intensive care admissions compared to similar inflammatory conditions.
As well as a fever, which was present in all cases, children presented with a variety of other symptoms, including shock, vomiting and abdominal pain. Data also showed that 78% of admissions were Black, Asian, or Minority Ethnic children. Encouragingly, the majority of children were discharged from hospital/PICU within one week, however two children sadly died.
Most of the children did not have active evidence of COVID-19 infection, but did have antibodies to COVID-19, meaning they had been infected in the recent past. The study has demonstrated that high quality intensive care support is essential for children who are seriously affected. Rapid national collaborations such as this are the key to unlocking knowledge that improves current treatment and aids the ongoing search for drugs to prevent or treat this condition.
Dr Patrick Davies, lead researcher and Consultant Paediatric Intensivist at the Nottingham Children’s Hospital said: “The vast majority of the critically ill children we describe had a short stay in PICU and were thankfully discharged. Although it can cause significant illness, this condition appears to be rare. The key to successful treatment is close collaboration between many specialties”.
Dr Barney Scholefield, senior author, Paediatric intensive care consultant at Birmingham Women’s and Children’s NHS Foundation Trust and researcher at the University of Birmingham said: “A large group of children’s intensive care clinicians from across the NHS have rapidly worked together to help understand this condition. The successful collaboration has resulted in a wealth of information to help treat cases currently and in any future waves of COVID-19.”
Dr Padmanabhan Ramnarayan, senior author and Consultant in Paediatric Intensive Care Retrieval at Great Ormond Street Hospital said: “This is a new condition and, in just a matter of weeks, clinicians across the world have already made tremendous progress in understanding it. However, many aspects of the condition remain unclear, such as why it only affects some children or what the long-term implications of having this condition are. One of our findings is that complications such as coronary aneurysms do occur in a small minority of patients. This clearly highlights the importance of following up on these patients – and this will be high on the agenda for clinical teams at GOSH and elsewhere.”
Other GOSH contributors towards the co-authoring of this paper include Mae Johnson, Pascale du Pre and Joe Brierley.
The Royal College of Paediatrics and Child Health has published advice for parents who are concerned about PIMS-TS. www.rcpch.ac.uk/resources/pims-covid-19-linked-syndrome-affecting-children-information-families
Notes to editors
For further information or to speak to a spokesperson from Nottingham University Hospitals, please contact Matthew Yorke, Communications Officer, Nottingham University Hospitals on 0115 924 9924 ext. 81214 or 07812 268 116
For more information or to contact a spokesperson from the University of Birmingham, please contact Sophie Belcher, Communications Manager (Medical and Dental Sciences) on +44 07815607157. Alternatively, contact the Press Office out of hours on +44 (0)7789 921165.
For further information or to speak to a Great Ormond Street Hospital spokesperson, please contact Astrid Baez in the GOSH Press Office at Astrid.Baez@GOSH.org or on 0203 841 3039.
For further information or to speak to a spokesperson from the Royal College of Paediatrics and Child Health, please contact Carmel Turner, Senior Media Lead on 07772 686022
About the University of Birmingham
The University of Birmingham is ranked amongst the world’s top 100 institutions, and its work brings people from across the world to Birmingham, including researchers and teachers and more than 6,500 international students from nearly 150 countries.
About Great Ormond Street Hospital for Children NHS Foundation Trust
Founded in 1852, Great Ormond Street Hospital is one of the world’s leading children’s hospitals with the broadest range of dedicated, children’s healthcare specialists under one roof in the UK. With more than 252,000 outpatient and 43,000 inpatient visits every year, the hospital’s pioneering research and treatment gives hope to children from across the UK with the rarest, most complex and often life-threatening conditions. As an international centre of excellence in child healthcare, our patients and families are central to everything we do – from the moment they come through the door and for as long as they need us.
About the UCL Great Ormond Street Institute of Child Health (ICH)
The UCL Great Ormond Street Institute of Child Health (ICH) is part of the Faculty of Population Health Sciences within the School of Life and Medical Sciences at University College London. Together with its clinical partner Great Ormond Street Hospital for Children NHS Foundation Trust (GOSH), it forms the UK's only paediatric National Institute for Health Research Biomedical Research Centre and has the largest concentration of children's health research in Europe. For more information visit www.ucl.ac.uk/ich
About Nottingham University Hospitals
Nottingham University Hospitals NHS Trust is one of the biggest and busiest acute hospitals in England, employing more than 16,500 staff. We provide care to over 2.5million residents of Nottingham and its surrounding communities and specialist services to a further 3-4million people from neighbouring counties.