cases of infantile inflammatory syndrome are increasing, but seem less severe

The risks of severe form and hospitalization for Covid-19 are low in children. But since the beginning of the year, due to the intense virus circulation at the end of 2021, “We are seeing a very marked increase in the number of cases of pediatric multisystem inflammatory syndrome (PIMS)”reported to Public Health France (SpF) in an alert at the end of January. Nearly a thousand cases have been identified since the start of the epidemic (964 cases as of February 10), with a median age of 8 years.

Rare, this inflammatory disease, which occurs on average two to six weeks following infection with SARS-CoV-2, nevertheless remains the most severe form of Covid-19 in children and adolescents. Indeed, regarding two thirds of these children with PIMS had to be admitted to intensive care or to a continuing care unit. Out of 4000 infections in children, one will have a PIMS. This disease affects 5.9 children under 18 per 100,000. One death of a 9-year-old child is to be deplored in France. Two-thirds of cases are additionally associated with acute myocarditis (inflammation of the myocardium, the main muscle of the heart). Most of the time, affected children have no comorbidity.

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“An increase in PIMS cases is expected, but the unknown lies in the magnitude of this increase”, says Professor Alexandre Belot, rheumato-pediatrician at the Woman-Mother-Child Hospital in Lyon. Reassuring point: “It cannot be ruled out that the clinical forms of PIMS linked to the Omicron variant will prove to be less severe”, underlines SpF in its note of January 23. Admittedly, few data come from countries ahead of the circulation of the Omicron variant such as the United States, the United Kingdom or South Africa. Corn “in England, paediatricians are seeing a continuous flow of cases, with fewer hospitalizations in specialist centres, however”, explains Alexandre Belot.

“The cases of PIMS seem less severe and less frequent, but it is still a little early to confirm these elements”indicated, during a meeting of the ANRS-emerging infectious diseases Thursday, February 10, François Angoulvant, pediatrician at the Robert-Debré hospital (AP-HP), who said ” to remain vigilant “. “At the hospital, we have the impression that the cases are less severe because they are better taken care of and earlier”adds Alexandre Belot.

No coronary artery disease

The first cases were described by pediatricians in April 2020, somewhat distraught in the face of symptoms suggestive of other diseases. In the first months of the epidemic, some children were even operated on for suspicion of appendicitis, and their condition did not improve in the following days. This led to monitoring of these atypical clinical pictures in the context of studies (coordinated by SpF, the research network of 42 pediatric intensive care units in France and learned societies).

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