Following the spread of the COVID-19 pandemic, a new disease entity emerged: pediatric inflammatory multisystem syndrome temporally associated with COVID-19 (PIMS-TS), or multisystem inflammatory syndrome in children (MIS-C). While children have been relatively spared from direct health-related consequences of COVID-19, the emergence of PIMS-TS has demonstrated the unique susceptibility of pediatric age groups to this rare but often life-threatening condition. PIMS-TS likely results from a multifactorial post-infectious process in which the host immune system mounts an excessive response to persistent COVID-19 antigens, possibly due to genetic predisposition. This exclusively pediatric disease is often complicated by shock and other life-threatening organ dysfunction requiring intensive care.
The long-term outcomes of PIMS-TS remain largely unknown, but survivors may be at increased risk of cognitive, behavioral or psychological sequelae known to affect up to a third of childhood survivors of critical illness. In addition, there is concern that, similar to Kawasaki disease, some children develop coronary or other cardiac alterations during the later course of the disease. To date, however there are no published results from randomized controlled trials in the field, and there is little data for optimal PIMS-TS management.
In the UK, an innovative study called RECOVERY is investigating the best treatment for PIMS-TS. RECOVERY is a multicenter open-label randomized-controlled platform study. The project Improving Recovery of Children Suffering from PIMS Associated with COVID (RECOVERY-PIMS) is a study hub set up in Switzerland that enables recruitment of children with PIMS-TS. It will assess short- and long-term outcomes of different treatments for PIMS-TS and aims to enable delivery of higher-quality, evidenced-based interventions leading to faster recovery and better outcomes for children. RECOVERY-PIMS will serve as a catalyst for efficient, cutting-edge, highly collaborative research networks across Swiss pediatric institutions.
The RECOVERY-PIMS project is being led by Luregn Schlapbach at the University Children’s Hospital Zurich (Switzerland).
Head of the Pediatric and Neonatal Intensive Care Unit
University Children’s Hospital Zurich