Today's Editorial - 07 June 2021
Source: By The Indian Express
A small study has reported most symptoms of rare paediatric inflammatory multisystem syndrome (PIMS-TS) associated with SARS-CoV2 are resolved after six months. Published in the Lancet Child and Adolescent Health , the study said that despite initial severe illness, most symptoms were resolved after six months in children who had PIMS-TS after contracting SARS-CoV-2 coronavirus infection.
PIMS-TS, also known as multisystem inflammatory syndrome in children (MIS-C), is a rare condition associated with SARS-CoV-2 infection that was first defined in April 2020. More than 250 cases were identified in the UK and Ireland from March to June, 2020. It is not known what triggers the condition, but it is thought to be a rare immune overreaction that occurs approximately four to six weeks after mild or asymptomatic SARS-CoV-2 infection.
The symptoms of the condition include fever, rash, eye infection, and gastrointestinal symptoms (e.g. diarrhoea, stomach-ache, nausea). In some rare cases, the condition can lead to multi-organ failure.
According to an observational study of 46 children, some children did experience problems at six months that require ongoing physical therapy and mental health support. All patients were treated at a specialist paediatric hospital, Great Ormond Street Hospital, UK, so the authors note that they represent more severe cases and further studies are needed to determine if the findings apply to all PIMS-TS patients.
All children had systemic inflammation when they were admitted to hospital, but none of the patients died. Most children experienced severe effects on different systems in the body during their initial illness, with 45 children experiencing gastrointestinal symptoms, 24 children neurological symptoms, and 15 children heart symptoms. At six months follow-up, most symptoms were resolved, with systemic inflammation gone in all but one child, echocardiograms in two children showed abnormalities, while six children were still had gastrointestinal symptoms.
Although small abnormalities were found on neurological examination in 18 children at six months, children experienced little difficulty walking and carrying out everyday tasks. The researchers say that this implies that any lasting neurological effects are probably mild and do not cause disability, although the test used might not be able to capture subtle effects, so they call for more detailed research on long-term neurological effects.
Muscle function improved significantly from hospital admission to six months, but in a six-minute walking test, 18 patients were in the bottom 3% for their age and sex after six months. As the study did not have a control group, the authors caution about the importance of interpreting this finding within the context of the pandemic.