Pediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2: a New Challenge amid the Pandemic
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COVID-19
Pediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2: a New Challenge amid the Pandemic Sherly Lawrensia 1 & Joshua Henrina 1,2 & Ellen Wijaya 3 & Leonardo Paskah Suciadi 2 & Aninka Saboe 4 & Charlotte Johanna Cool 4 Accepted: 15 October 2020 # Springer Nature Switzerland AG 2020
Abstract Initially, SARS-CoV-2 infection had been reported as a relatively mild case in children than in adults. Nevertheless, recent evidence found that a subset of children then developed a significant systemic inflammatory response that resembles atypical/ typical Kawasaki’s disease (KD) and toxic shock syndrome. This novel clinical syndrome later identified as pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS). In contrast with KD, PIMS-TS appears to occur in children at an older age with a predominance of gastrointestinal symptoms, hemodynamic instability, and myocardial dysfunction. However, the exact pathomechanism remains to be understood. Nevertheless, the post-viral immunological reaction is postulated to be the underlying mechanistic underpinnings. The multifaceted nature of the PIMS-TS’ course underlines the need for early recognition and multispecialty care and management. Keywords PIMS-TS . SARS-CoV-2 . COVID-19 . MIS-C . Hyperinflammatory syndrome
Introduction The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has rapidly spread throughout the world. As of 14 September 2020, data from the World Health Organization (WHO) showed that COVID-19 has affected almost twenty-nine million people and is attributable to more than 917.000 deaths [1]. Previously, SARS-CoV-2
infection has been reported as a relatively mild case in children than in adults [2]. Nevertheless, recent evidence revealed that a subset of children might develop significant complications of a systemic inflammatory response that resembles atypical/ typical Kawasaki’s disease (KD) and toxic shock syndrome [3]. This novel clinical syndrome has been later identified as pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS). Following the emergence of PIMS-TS, the WHO, Centers for Disease Control
This article is part of the Topical Collection on Covid-19 * Sherly Lawrensia [email protected] Joshua Henrina [email protected]
1
School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jl. Pluit Raya No. 2, RT 21/RW 08, Penjaringan, Kota Jakarta Utara, Daerah Khusus Ibukota Jakarta 14440, Indonesia
2
Siloam Heart Institute, Siloam Hospital Kebon Jeruk, Jl. Perjuangan No.8, RT.14/RW.10, Kb. Jeruk, Kec. Kb. Jeruk, Kota Jakarta Barat, Daerah Khusus Ibukota Jakarta 11530, Indonesia
3
Department of Pediatrics, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jl. Pluit Raya No. 2, RT 21/RW 08, Penjaringan, Kota Jakarta Utara, Daerah Khusus Ibu kota Jakarta 14440, Indonesia
4
Cardiology and Vascu
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