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Study finds link between ethnicity and childhood COVID-19 syndrome

Children from black ethnic groups are more at risk from a rare condition linked to COVID-19, called Paediatric Multisystem Inflammatory Syndrome (PIMS-TS), new research has found.

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Researchers from Evelina London Children’s Hospital and King’s analysed the associations of ethnicity and socioeconomic deprivation with risk and severity for children in the south-east of England admitted to Evelina London with PIMS-TS between February and June 2020.

Results from this preliminary study found of the 70 children diagnosed with PIMS-TS during the time period, 46 of those were admitted to the paediatric intensive care unit (PICU) at the south London hospital.

Published in the Archives of Childhood Diseases, the results show that children at increased risk are those from black, Asian and other ethnic groups, those that live in deprived socio-economic areas, and those families with a key worker. PIMS-TS cases were significantly higher in children from black ethnic groups, with 25.0 cases per 100,000. This is contrasted against 6.4/100,000 for children from Asian ethnic groups, and 1.6/100,000 for children from white ethnic groups.

The length of stay in hospital was 38% longer in children from black ethnic groups, compared to those in white ethnic groups, and nine out of 10 children requiring ventilation were from black ethnic groups.

Children from key worker families also made up 50% of the total cohort, with 21% of those having a household family member working in healthcare.

Joint first author, Dr Jonathan Broad, paediatric registrar at Evelina London, said: “Our study is the first of its kind, and showed different health impacts for children from certain ethnicities and socioeconomic groups. Although PIMS-TS is rare, research found that ethnicity was a key factor in children with longer hospital stays and was associated with a need for intensive care ventilation.

“This study is really important as it is the first to assess the direct health impact of the COVID-19 pandemic on children and young people who are diagnosed with PIMS-TS. It highlights the urgency needed in tackling health inequalities which start from a young age.”

“In adults, COVID-19 risk and severity have been associated with ethnicity and socioeconomic status. In this work, we observe the same patterns. However, the disparities may be even greater with PIMS-TS in children. The stark disparities we found in this research are alarming. Work is urgently needed to understand the causes of these disparities, and identify ways to address them.– Joint lead author Dr Julia Forman, from the School of Life Course Sciences

PIMS-TS was first reported by clinical teams at Evelina London last April following a cluster of six children admitted to PICU who had displayed hyper-inflammatory symptoms similar to Kawasaki Disease or toxic shock. Symptoms of PIMS-TS can include a prolonged fever, widespread red rash, diarrhoea and/or vomiting, and not feeling or acting like themselves.

Dr Jonathan Broad added: “This illness is rare and the children and young people we’ve seen with PIMS-TS have responded very well to hospital treatment. We continue to monitor them through regular check-ups afterwards.

“It is a serious condition so we want families to be aware so they know what to look out for and when to contact a health professional if they are worried about their child.”

If your child has any of the symptoms, you should call your GP or NHS 111 for advice. If your child develops chest pain, or severe breathing difficulties call 999 immediately.

In this story

Julia  Forman

Julia Forman

Lecturer in Applied Statistics and Epidemiology