Biomarker profile in pediatric inflammatory multisystem syndrome temporarily associated with SARS-CoV-2 (PIMS-TS)/multisystem inflammatory syndrome in children (MIS-C)

Abstract

Pediatric Inflammatory Multisystem Syndrome temporarily associated with SARS-CoV-2 (PIMS-TS) or Multisystem Inflammatory Syndrome in Children (MIS-C) is a post COVID-19 multisystem inflammatory syndrome in children and adolescents <21 years of age. It is slowly emerging in India with clinical features overlapping with Kawasaki Disease (KD) and Toxic Shock Syndrome (TSS). Ten PIMS-TS cases admitted in a pediatric hospital between July and Sept 2020 were compared with 19 Kawasaki Disease (KD) patients’ data. The median age of PIMS-TS was 6 years (older to KD), 80% were males. PMS-TS cases had high inflammatory markers: CRP, ferritin, interleukin (IL)-6. Other distinct features were lymphopenia, hypoalbuminemia, and hyponatremia. Serial measurements of CRP showed high baseline values with subsequent decrease. NT-Pro BNP level was extremely elevated; suggestive of cardiac injury. All patients recovered. Laboratory features of PIMS-TS present a unique pattern of intense inflammation, and cardiac involvement that is different from features of pre COVID-19 KD. CRP remains a useful, inexpensive marker for PIMS-TS diagnosis and clinical progression.