key: cord-0061585-4lykln1j
authors: nan
title: Paediatric inflammatory multisystem syndrome temporally associated with SARS‐CoV‐2 infection
date: 2021-02-18
journal: J Paediatr Child Health
DOI: 10.1111/jpc.15208
sha: 1a0cae1d719417d66517513851cfda16c9c1a53b
doc_id: 61585
cord_uid: 4lykln1j

nan

Rapid genome testing of critically ill neonates and children with suspected genetic conditions has gained momentum. However, it has been limited by cost, availability and timeliness. Twelve Australian hospitals and two laboratories formed a network aiming to test the feasibility of selecting patients with suspected monogenic conditions and delivering genomic results in less than 5 days (as opposed to the usual 7-23 days) in a public health system. 1 From March 2018 to February 2019, ultra-rapid exome sequencing was performed on 108 in-patients aged 0 days to 17 years (median 28 days); a definitive molecular diagnosis was made in 55 (51%) patients. Males predominated (66%). Most patients (57%) were from neonatal units, 33% from paediatric intensive care units and 9% from wards. Mean time from hospital admission to sequencing report was 3.3 days (95% confidence interval 3.2-3.5) and 93 reports (86%) were received before death or hospital discharge. Clinicians considered clinical management was influenced by the sequencing result in 42 (76%) of 55 patients with a molecular diagnosis and six (11%) of 53 without. Targeted treatment was commenced in 12 (11%) children, management was re-directed to palliative care in 14 (13%) and surveillance for known complications initiated for 19 (18%). 

Children are at lower risk than adults of catching and of developing severe illness with SARS-CoV-2 infection. However, a syndrome has emerged associated with SARS-CoV-2 infection in which children develop persistent fever and laboratory evidence of inflammation. An English case series described 58 children admitted to one of eight hospitals over 8 weeks who met the case definition for paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS). 1 Girls predominated (33, 57%). SARS-CoV-2 was detected by polymerase chain reaction in 15 (26%) of 58 and specific IgG antibody in 40 (87%) of 46 tested. Symptoms included fever (100%), abdominal pain (53%), diarrhoea (52%), vomiting (45%), rash (52%) and conjunctival infection (45% 

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