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Childhood syndrome linked to COVID-19 causes profound immune changes

A new study has shed light on a rare disease associated with COVID-19 in children.

covid-child-pimst

Research published today in Nature Medicine examines the clinical characteristics of paediatric inflammatory multisystem syndrome (PIMS-TS).

PIMS-TS is a rare syndrome which has emerged in a small number of children during the COVID-19 pandemic. The condition causes severe inflammation in blood vessels and can lead to heart damage.

A team from King’s and the Evelina London Children’s Hospital analysed blood samples from 25 children who had PIMS-TS and compared these to healthy children. These samples were tested from these children at different stages of the disease, from the acute phase upon admission to hospital, through to their outpatient appointments.

The study showed that in the acute stage of PIMS-TS, children have raised levels of molecules called cytokines, and reduced levels of white blood cells called lymphocytes. They saw that by the time the children had recovered, the immune system changes had gradually returned to normal.

Although the cohort is small, this is the first evidence to show the role of the immune system in the disease. It provides vital evidence for future research and will indicate what treatments may help patients with the condition.

It also confirms that PIMS-TS affects the body in a different way to other known conditions, such as Kawasaki disease, and has been identified as a new syndrome.

PIMS-TS is a new syndrome. Our research has allowed us to provide the first description of the profound immune system changes in severely ill children with this new illness. These immune changes are complex. The innate, otherwise known as the rapidly responding, immune cells are activated. The lymphocytes, a particular type of white cell involved in specific protective immunity, are depleted, but appear to be actively fighting infection. – Dr Manu Shankar-Hari from the School of Immunology and Microbial Sciences,

He added: “Clinically, these children respond to treatments that calm the immune system such as corticosteroid and immunoglobulins. Although there are similarities to existing conditions such as Kawasaki Disease, these clinical and immunological changes that we observe imply that PIMS-TS is a distinct illness associated with SARS-Co-V-2 infections.”

In this story

Manu Shankar-Hari

Manu Shankar-Hari

NIHR Clinician Scientist, Reader and Consultant in Intensive Care Medicine

Michael  Carter

Michael Carter

NIHR Academic Clinical Lecturer in Paediatrics