Pediatric Inflammatory Multisystem Syndrome Temporally Associated with Covid-19 (Pims-Ts) in Moroccan Picu

ABSTRACT

BACKGROUND AND AIM: Pediatric inflammatory multisystem syndrome temporally associated with COVID- 19(PIMS-TS)is a new spectrum of COVID-19's related clinical manifestations associated to increased inflammatory markers. We aim to describe clinical and biological characteristics of PIMS-TS patients admitted to PICU. METHOD(S) Were included children (1month -14years old) admitted to our PICU from March to October2021 for PIMSTS according to WHO's definition. RESULT(S) Ten patients (6 girls/4 boys) were included. Mean age was 8 years(1.8-13 years). Clinical manifestations Fever (all cases, mean duration5 days);gastrointestinal symptoms (3 cases);mucocutaneous signs (8 cases), neurological impairment(3 cases). Shock was diagnosed in 6 cases and hypoxemia in 4 cases. RT-PCR of SARS-COV2 was negative while Serology returned positive in all cases. Biology assessment Mean white blood cells account was 21154 E/mm3 (14783- 48190 E/mm3);mean lymphocytes account was 1047,2 (651-1610 E/mm3);mean C-reactive protein was 247,2 mg/l (147-401mg/l);hyperferritinemia >500 ng/ml was noted in 8 cases with a mean level of 712,4 ng/ml (543-1004 ng/ml);D-Dimeres level>1000mug/ml in all cases with a mean level of 2076,2 ng/ml (1100-3292 ng/ml);Troponin were positive in 7 patients with a mean level of 53,7 (12-120ng/l). Transthoracic echocardiogram was normal in 4 cases, ventricular dysfunction was objectified in 6 cases. Mechanical ventilation was necessary in three cases. Vasoactive support was administrated in 7 cases. Bolus of methylprednisolone associated to intravenous immunoglobulins were administrated in 8 cases. The average length of PICU stay was 6 days (2-10 days). The outcome was favorable in 7 cases. CONCLUSION(S) PIMS-TS has multiple faces and can be lethal in children.