PIMS syndrome: Doctors describe the disease in children as “difficult to grasp”. The first symptoms are usually unremarkable.
A corona infection has many faces. The virus shows a wide variety of symptoms in infected people. And children in particular are at great risk in the pandemic. Not only is the RS virus becoming a big problem for the little ones*, as echo24.de * has already reported, a direct consequence of a supposedly mild Covid disease also poses a deadly risk for children – the PIMS syndrome.
As early as May 2021, paediatricians in particular increasingly drew attention to the corona risk PIMS. In a report by ZDF today , Christian Dohna-Schwake, specialist in pediatrics, drew attention to the extremely tense situation.
PIMS syndrome: what is behind the disease?
PIMS stands for Pediatric Inflammatory Multiorgan. According to the Deutsche Apotheker Zeitung , this syndrome is a rare ” but dangerous late consequence of an often symptom-free COVID-19 infection” in children and adolescents. Dohna-Schwake made it clear in the ZDF article from November: “The situation is currently very tense in many children’s hospitals because the other respiratory viral diseases are currently more common than in the “normal” autumn-winter seasons.”
According to the report, one in 1,000 children is affected by a dangerous overreaction of the immune system, the so-called PIMS syndrome, after a Covid infection and can be placed in intensive care as a result. Whether and how vaccination can help is discussed. At the end of November, the state government of Baden-Württemberg again commented on the subject of corona vaccination for children *. The Ministry of Health in Stuttgart* was ready to talk about the topic.
Consequence of a corona disease in children: The great PIMS danger
The big problem with PIMS syndrome is detection. Opposite the diakoneo.de portal, Senior Physician Dr. Ulrich Keck from the Diakoneo Diak Klinikum in Schwäbisch Hall said it was ” difficult to grasp ” because, in addition to the high fever and poor condition, there are often other symptoms, some of which are only fleeting and last for a few days. There are therefore signs of both a viral and a bacterial infection.
dr Ulrich Keck: “Since a severe bacterial infection cannot be ruled out initially, the vast majority of children initially receive antibiotic therapy. After about 5 to 10 days, without any apparent improvement, the children receive immunoglobulins for 12 hours, followed by cortisone.”
immunoglobulins
Immunoglobulins are vital proteins that circulate in the blood and perform a variety of tasks. They are an important part of our immune system.
So far, there are no precise guidelines for the appropriate treatment method. There is a lack of sufficient data on the PIMS syndrome. Therefore, doctors usually follow the treatment guidelines for Kawasaki syndrome. Kawasaki syndrome* is a vascular inflammation of the small and medium-sized arteries. The possible involvement of the coronary arteries is particularly significant.
Study on the PIMS syndrome: parallels to the peak in corona hospitalization
The German Society for Pediatric Infectious Diseases (DGPI) has dealt with the topic of pediatric inflammatory multi-organ. And this German scientific society of physicians started recording and evaluating cases of PIMS in May 2020. The DGPI writes: “From the beginning of our PIMS recording on May 27, 2020 to December 5, 2021, 477 children and adolescents were reported who meet the WHO case definition we chose. A retrospective recording was possible” .
paediatrics
Paediatrics or pediatrics is the study of the development of children and adolescents. The focus is on the different diseases and their treatment and prevention.
According to its own definition, the German Society for Pediatric Infectious Diseases tries to “promote the scientific and practical concerns of pediatric infectiology and to expand and disseminate knowledge about pathogen-related diseases in children and adolescents” .
PIMS cases were evaluated “if, in addition to fever, increased systemic inflammation parameters, at least two organ involvements and evidence of a current (positive SARS-CoV-2PCR or antigen detection) or fed up (positive SARSS-CoV serology) SARS-CoV-2 infection or a SARS-CoV-2 contact could be proven, and other infectious causes could be ruled out” .
A PIMS disease peak was identified in late December 2020, which occurred in parallel with the peak of COVID-19 hospitalizations in children and adolescents. In contrast to the Corona cases, however, children with PIMS are older and more male. Also, PIMS cases may be associated with underlying diseases less often than Covid cases.
Symptoms of PIMS: Unassuming first signs
The first symptoms of a PIMS disease are rather unsuspicious – and therefore extremely dangerous. Diakoneo called high fever over 40 degrees, vomiting, diarrhea. There are no signs of a serious secondary disease from Corona. Only a corona antibody test in a clinic can provide certainty as to whether it is PIMS. In the Diakoneo article, Prof. Michael Schroth, chief physician for pediatrics and neonatology at the Cnopf Children’s Hospital in Nuremberg, explains: “Children often do not show any symptoms of corona virus infections, but they still go through the disease.”
The children’s immune system only goes completely haywire after the corona disease: “With PIMS, the immune system runs amok, so to speak. It is a veritable inflammatory storm: Various organs and blood vessels can be affected. However, the course varies greatly from child to child.” First symptoms:
- high fever over 40 degrees
- Vomit
- diarrhea
- stomach pain
- marked redness of the palms and soles
The consequences of PIMS: Undetected, it can be deadly
The consequences of PIMS can be very serious. Senior Physician Dr. Ulrich Keck from the Diakoneo Diak Klinikum in Schwäbisch Hall describes the consequences: “In the context of cardiac involvement, the affected children usually develop mild to moderate cardiac muscle weakness, which can also improve quickly. However, complications arise in 5 to 20 percent of cases in the form of a bulging of the coronary arteries. In the worst case, these can lead to a child’s heart attack. At this point in time, we cannot say whether further chronic organ damage is possible.”
In a daily news report, Prof. Dr. Christoph Fusch, chief physician at the clinic for newborns, children and adolescents at the Nuremberg Clinic, on the procedure for examining children with PIMS: “There are children who are very mildly affected, there are children who are also really sick and the vessels change. That’s why we look in the organ systems: in the brain, in the heart and have to see whether changes are taking place there.”
According to the medical journal , the PIMS syndrome usually occurs 2-8 weeks after an asymptomatic SARS-CoV-2 infection or COVID-19 disease. The Deutsche Apotheker Zeitung warns: “If left untreated, the symptoms, which begin with abdominal pain and fever and can extend to severe cardiovascular disorders and neurological failures, can be fatal.” After all, it is reassuring: According to numerous experts, PIMS can be treated very well, for example with cortisone. According to the DGPI, no fatal outcomes have been reported so far. * echo24.de is an offer from IPPEN.MEDIA.
Rubriklistenbild: © picture alliance / Wavebreak Media/dpa
