Our experience with pediatric inflammatory multisystem syndrome associated with COVID-19 (PIMS-TS)

Authors: M. Igaz 1;  M. Kostková 1;  T. Bělohlávek 2;  F. Olekšák 1;  M. Jeseňák 1;  P. Bánovčin 1
Authors‘ workplace: Klinika detí a dorastu, Jesseniova lekárska fakulta v Martine, Univerzita Komenského v Bratislave, Univerzitná nemocnica Martin, Slovensko 1;  Klinika detskej anesteziológie a intenzívnej medicíny, Jesseniova lekárska fakulta v Martine, Univerzita Komenského v Bratislave, Univerzitná nemocnica Martin, Slovensko 2
Published in: Čes-slov Pediat 2021; 76 (1): 10-17.


COVID-19 is usually asymptomatic or mild in the pediatric population. This is mainly due to the absence of other diseases that could worsen the condition with their clinical manifestation, but also, for example, the influence of androgens on ACE2 receptor expression. The number of hospitalizations in pediatric patients with acute COVID-19 has been low since the onset of the pandemic. However, in April 2020, the World Health Organization drew attention to the increasing number of hospitalizations of pediatric patients, especially in intensive care units with clinical symptomatology similar to sepsis, Kawasaki syndrome, toxic shock syndrome or activated macrophage syndrome. The condition was associated with acute or past SARS-CoV-2 infection.

The authors present two case reports of pediatric patients with fully expressed clinical symptomatology of pediatric inflammatory multisystem syndrome. The clinical picture was dominated by febris remittens, cardiac insufficiency, non-purulent conjunctivitis, palmar and plantar erythema, rash. High inflammatory activity and positive antibodies against SARS-CoV-2 in the IgG class were present in the laboratory parameters. They were treated with intravenous immunoglobulins, systemic corticoids, anticoagulants and antiplatelet drugs. Vasoactive and inotropic support and in one case artificial lung ventilation were needed. An adequate effect of immunosuppressive and subsequent immunomodulatory treatment was observed in both patients.


COVID-19, PIMS-TS, pediatric multisystem inflammatory syndrome temporaly associated to COVID-19


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Neonatology Paediatrics General practitioner for children and adolescents

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