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CHE COSA È LONG COVID?

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Paediatric Inflammatory Multisystem Syndrome
Also Known As Multisystem Inflammatory Syndrome In Children

Paediatric Inflammatory Multisystem Syndrome is deemed to be a rare condition thought to be triggered by COVID-19. Although it is a relatively new condition, it can be detected early and treated successfully. It is often referred to as PIMS-TS or PIMS for short.

If you are concerned that your child has PIMS please seek immediate medical attention without delay. You may find it helpful to show your Doctor the information on this page.

The Symptoms of PIMS
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Some children may not experience all the symptoms

What are the symptoms of PIMS?

The main symptom of PIMS is a high temperature that lasts for a few days

The following symptoms can occur in conjunction with a temperature and you should seek immediate medical advice: 

 

  • A rash

  • Tiredness and weakness

  • Tummy pain or cramps

  • Red and or cracked lips

  • Swollen hands and feet

  • Peeling skin on your hands and feet

  • Headache

  • Red eyes

  • Muscle aches and pains

  • Diarrhoea and vomiting

  • Swollen neck glands

  • Unexplained irritability

If your child develops chest pain, please call the emergency services immediately.

Frequently asked questions

Are PIMS and MISC the same thing?


Yes. PIMS Paediatric Inflammatory Multisystem Syndrome in Children is the name usually used in the UK for the paediatric complication that children and young people can develop following COVID-19 infection. MISC Multisystem Inflammatory Syndrome in Children is the name usually used in the USA and other countries for the paediatric complication that children and young people can develop following COVID-19 infection.




What is PIMS?


PIMS has similar characteristics to Kawasaki Disease, a form of vasculitis that causes swelling of the blood vessels throughout the body. Doctors report that Kawasaki Disease is more common in children under the age of five and that Kawasaki Disease is more common in boys than girls. Doctors report that PIMS affects older children and teenagers and is the paediatric complication linked to COVID-19. It is worth noting that the Long Covid Kids Support Group has a number of childlren under the age of 10 with a PIMS diagnosis.




What are the symptoms of PIMS?


The symptoms of PIMS are numerous. The main symptom of PIMS is a high temperature that lasts for a few days. The following symptoms can occur in conjunction with a temperature:

  • A rash
  • Tiredness and weakness
  • Tummy pain or cramps
  • Red and or cracked lips
  • Swollen hands and feet
  • Peeling skin on your hands and feet
  • Headache
  • Red eyes
  • Muscle aches and pains
  • Diarrhoea and vomiting
  • Swollen neck glands
  • Unexplained irritability
If you think your child has additional symptoms, that may or may not be linked to PIMS, report them to your doctor. More infomation from the Evelina Childrens Hospital More information from the Evelina Childrens Hospital More information from the CDC for parents More inforamtion from the CDC for clinicians




What should I do if my child is unwell with these symptoms?


Contact your doctor for immediate medical advice. In the UK you can call 111. Contact the emergency services if you are concerned. In the UK you can call 999. There aren't any specific blood tests for PIMS. To rule out PIMS your Doctor will need to perform blood tests to look for inflammatory markers, they will look to see how your child is functioning, and monitor your child's symptoms. The doctor will consider the information available and decide if your child has PIMS and which treatment will help your child. If your child is not diagnosed with PIMS and continues to have symptoms consistent with PIMS please get a second opinion.




What if my child has not had Coronavirus?


Children can experience asymptomatic illness with COVID-19. This means a child may have had COVID-19 without showing any symptoms. Some children diagnosed with PIMS tested negative for COVID-19, but positive for the specific antibodies used to identify a previous infection of COVID-19. A positive antibody test is not required for a diagnosis of PIMS. It is worth noting that research reports that some people who tested positive for COVID-19 did NOT have antibodies after infection. Seek medical advice if your child has the symptoms of PIMS even if you don't think they have previously had COVID-19. A Doctor can rule out PIMS and other conditions which can be fatal in children.




How is PIMS treated?


A combination of medicine is used to calm down the immune system that causes the inflammation in the body. Typical treatment includes: IVIG - Intravenous immunoglobulin A blood thinner - Such as Aspirin / Clexane Steroids Treatment must be perscribed by a doctor. More infomation from the Evelina Childrens Hospital for parents More information from the Evelina Childrens Hospital for clinicians More information from CDC for parents More information from the CDC for clinicians




Are children hospitalised with PIMS?


720 PIMS admissions were recorded to the end of February 2021 in England in addition to the COVID-19 admissions. We have been unable to find any public data on PIMS admissions since February 2021.




Do children die from PIMS?


Yes although, thankfully it is very rare. Until December 2021 we were uable to find any public data recording children who have died from PIMS. In December 2021 - 1 child was recorded. This is why children and young people should be seen by a doctor and receive prompt treatment if required.




What follow up care should be offered to a child recovering from PIMS?


According to the American Academy of Paediatrics ( AAPS) children diagnosed with PIMS should recceive;

  • Outpatient paediatric cardiology follow-up starting 1 to 2 weeks after discharge from hospital. Timing should be determined in consultation with a pediatric cardiologist
  • Children with myocardial injury must have cardiology directed restriction and/or release for activities.
  • Children who receive steroid therapy or treatment with biologics should receive follow-up with the paediatric rheumatologist following discharge.
  • Primary care follow-up is recommended for all patients.




Should patients with a history of PIMS receive the COVID-19 vaccine?


According to the AAP in the USA children with a history of PIMS should consider delaying vaccination until after they have recovered from illness (including return to normal cardiac function) and for at least 90 days following their diagnosis of MIS-C. Currently, there are limited data about the safety and efficacy of COVID-19 vaccine in children with a history of PIMS. It is recommended that paediatricians and families should participate in shared decision making and consider risks and benefits of COVID-19 vaccination for each individual patient. The CDC offers additional guidance. Children who have received monoclonal antibodies or convalescent plasma as part of their treatment should wait at least 90 days prior to receiving COVID-19 vaccine.




Are Black or Asian children more likely to be affected?


Children from all ethnic minority backgrounds are reported to be affected by PIMS. There have been more children affected by PIMS who are from Black and Asian backgrounds, but it is not yet clear why.





What we know about MIS-C

Multisystem inflammatory syndrome in children (MIS-C) is a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs.

 

We do not yet know what causes MIS-C.

 

However, we know that many children with MIS-C had the virus that causes COVID-19, or had been around someone with COVID-19.

 

The CDC states that MIS-C can be serious, even deadly, but that most children who were diagnosed with this condition have recovered with medical care.

Read more from the CDC

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