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Children’s Health Queensland Hospital and Health Service Children’s Health Queensland Hospital and Health Service

Paediatric inflammatory multisystem syndrome

Paediatric multisystem inflammatory syndrome – temporally associated with SARS-CoV-2 (or PIMS-TS) is the current name given to the rare hyperinflammatory state seen in children who have been infected with SARS-CoV-2 (the coronavirus that causes COVID-19). Most children and young people don’t become seriously unwell with COVID-19, but a very small number (less than 0.5 %) around the world have developed a condition where different parts of the body become inflamed usually between two to four weeks afterwards.

Most children with PIMS-TS will not be seriously affected but, in a very small number of cases, it can be serious.

What causes the syndrome?

Research into PIMS-TS is ongoing but it does appear to be linked to the SARS-CoV-2 coronavirus.

Inflammation is a normal response of the body’s immune system to an infection but PIMS-TS causes the immune system to go into overdrive and start attacking the body.

Signs and symptoms

The main signs and symptoms of PIM-TS include:

  • Fever (persists over several days)
  • Stomach pain
  • Diarrhoea
  • Vomiting
  • Chest tightness/pain
  • Extreme tiredness
  • Rash
  • Cold hands
  • Red eyes

Please note, these symptoms can be found in other illnesses, too. Not all of these symptoms will be present and different children may be affected differently by PIMS-TS.

When to seek help

Seek medical help immediately by calling 000 if a child has any of the following:

  • Discoloured or blotchy skin, or skin that is very pale or bluish
  • Trouble breathing
  • Persistent pain or pressure in the chest
  • Confusion
  • Inability to wake or stay awake

How is PIMS-TS diagnosed?

There is currently no single test to diagnose PIMS-TS with certainty but doctors can look for a pattern of symptoms relating to PIMS-TS and then order a series of tests, such as blood pressure and blood analysis, chest X-ray, and a heart ultrasound, to make a diagnosis. These tests will show if there is any other cause for these symptoms and if there is any evidence that inflammation has affected blood vessels.

Treatment

Treatments to reduce inflammation in the body may be needed. Most children who become ill with PIMS will need to be treated in the hospital. Some will need to be treated in the paediatric intensive care unit (PICU). Most children are expected to recover fully.

Key points

  • PIMS-TS is a rare hyperinflammatory state seen in children who have had COVID-19.
  • Seek medical help immediately if your child has discoloured or blotchy skin, skin that is very pale or bluish, trouble breathing, persistent pain or pressure in the chest, seems confused or you are unable to wake them or keep them awake.
  • Most children with PIMS-TS will not be seriously affected but, in a very small number of cases, it can be serious.
  • Children are expected to recover from PIMS-TS.

Developed by the Infectious Diseases Department, Queensland Children’s Hospital. We acknowledge the input of consumers and carers.

Resource ID: FS150 Reviewed: Aug 2021

Disclaimer
This information has been produced by healthcare professionals as a guideline only and is intended to support, not replace, discussion with your child’s doctor or healthcare professionals. Information is updated regularly, so please check you are referring to the most recent version. Seek medical advice, as appropriate, for concerns regarding your child’s health.

CHQ