Status: 09.02.2022 3:26 p.m
The corona infection was mild, but weeks later the child reacted with a high fever and signs of inflammation: around 660 children have had PIMS syndrome so far, and the number of unreported cases is likely to be significantly higher.
The corona infection is rather harmless in many children, and the little ones usually recover quickly. But in rare cases, weeks after recovery, severe inflammatory reactions with high fever can set in – experts then speak of multisystem inflammatory syndrome PIMS. In Germany, around 1,000 children may have contracted PIMS as a result of a corona infection since the beginning of the pandemic.
Around 660 cases have been reported since May 2020 (as of February 6), like one Register of the German Society for Pediatric Infectious Diseases (DGPI) emerges, which is based on voluntary reports from more than half of the children’s hospitals and departments in Germany. “With the number of unreported cases, there should be around 1,000 people affected by PIMS,” said the paediatrician Jakob Armann from the University Hospital Dresden, who manages the reports to the register, of the dpa news agency. In view of the high number of infected people nationwide, it is a rare disease.
Severe disease that is easily treatable
The abbreviation PIMS stands for “Pediatric Inflammatory Multisystem Syndrome”. Typical signs are fever lasting several days as well as diarrhea and/or skin rashes typically four to eight weeks after a Sars-CoV-2 infection. Even children without previous illnesses can be affected.
According to Armann, a little more than half of the reported PIMS patients received intensive care. “Although it is a serious illness, it is easy to treat. As a rule, affected children can leave the intensive care unit after two to five days.” Permanent damage usually does not occur. “Of course it’s not a pretty disease, but it’s also not something that pushes the children’s hospitals to their breaking point.”
An increase in cases was observed from around mid-December both in the register and in the Dresden clinic, explained Armann. This can certainly be explained by the generally high number of cases, since PIMS occurs with a certain probability after a Sars-CoV-2 infection – regardless of its severity. One PIMS case is assumed for every 4000 infections.
Boys are affected more often
Around two thirds of the cases recorded in the register were boys. According to the expert, the cases are evenly distributed across all age groups. Especially at the beginning of the pandemic, the corona infection that had gone through was sometimes only recognized retrospectively in blood tests based on the antibodies.
Despite the recent increase in PIMS numbers, the level this winter is somewhat lower than a year ago. “It’s probably an effect of the Delta variant,” Armann explained. The variant that will prevail in autumn and winter 2021 seems to trigger PIMS a little less frequently than the previous variants. This was suggested by data from different countries. “It’s not necessarily the case that the disease gets worse with every mutation in the virus,” Armann said.
Vaccination also protects here
The impact of the new Omikron variant cannot be assessed at this time due to the delayed occurrence of PIMS. It should also be borne in mind that the proportion of those vaccinated is also growing among children and young people. According to the CDC, giving two doses of the Biontech/Pfizer vaccine to children and adolescents 12 to 18 years of age provides a high level of protection against PIMS.
Cases of children with severe inflammatory reactions in connection with Corona were noticed in several countries in spring 2020. Similar clinical pictures in children were already known – one example is the so-called Kawasaki syndrome, the cause of which is not entirely clear to this day. Presumably, this is also the result of an infection, as Armann explained. “Outside of a pandemic, however, the exact cause is difficult to find. After all, children have antibodies against a wide variety of pathogens.” Before Corona, it was assumed that there were 400 to 500 cases of Kawasaki syndrome in children per year in Germany.