Best Practice Recommendations for the Diagnosis and Management of Children With Pediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2 (PIMS-TS; Multisystem Inflammatory Syndrome in Children, MIS-C) in Switzerland.

Schlapbach, Luregn J; Andre, Maya C; Grazioli, Serge; Schöbi, Nina; Ritz, Nicole; Aebi, Christoph; Agyeman, Philipp; Albisetti, Manuela; Bailey, Douggl G N; Berger, Christoph; Blanchard-Rohner, Géraldine; Bressieux-Degueldre, Sabrina; Hofer, Michael; L'Huillier, Arnaud G; Marston, Mark; Meyer Sauteur, Patrick M; Pachlopnik Schmid, Jana; Perez, Marie-Helene; Rogdo, Bjarte; Trück, Johannes; ... (2021). Best Practice Recommendations for the Diagnosis and Management of Children With Pediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2 (PIMS-TS; Multisystem Inflammatory Syndrome in Children, MIS-C) in Switzerland. Frontiers in Pediatrics, 9(667507), p. 667507. Frontiers 10.3389/fped.2021.667507

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Background: Following the spread of the coronavirus disease 2019 (COVID-19) pandemic a new disease entity emerged, defined as Pediatric Inflammatory Multisystem Syndrome temporally associated with COVID-19 (PIMS-TS), or Multisystem Inflammatory Syndrome in Children (MIS-C). In the absence of trials, evidence for treatment remains scarce. Purpose: To develop best practice recommendations for the diagnosis and treatment of children with PIMS-TS in Switzerland. It is acknowledged that the field is changing rapidly, and regular revisions in the coming months are pre-planned as evidence is increasing. Methods: Consensus guidelines for best practice were established by a multidisciplinary group of Swiss pediatric clinicians with expertise in intensive care, immunology/rheumatology, infectious diseases, hematology, and cardiology. Subsequent to literature review, four working groups established draft recommendations which were subsequently adapted in a modified Delphi process. Recommendations had to reach >80% agreement for acceptance. Results: The group achieved agreement on 26 recommendations, which specify diagnostic approaches and interventions across anti-inflammatory, anti-infectious, and support therapies, and follow-up for children with suspected PIMS-TS. A management algorithm was derived to guide treatment depending on the phenotype of presentation, categorized into PIMS-TS with (a) shock, (b) Kawasaki-disease like, and (c) undifferentiated inflammatory presentation. Conclusion: Available literature on PIMS-TS is limited to retrospective or prospective observational studies. Informed by these cohort studies and indirect evidence from other inflammatory conditions in children and adults, as well as guidelines from international health authorities, the Swiss PIMS-TS recommendations represent best practice guidelines based on currently available knowledge to standardize treatment of children with suspected PIMS-TS. Given the absence of high-grade evidence, regular updates of the recommendations will be warranted, and participation of patients in trials should be encouraged.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine > Paediatric Infectiology

UniBE Contributor:

Aebi, Christoph and Agyeman, Philipp Kwame Abayie

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2296-2360

Publisher:

Frontiers

Language:

English

Submitter:

Christoph Aebi

Date Deposited:

29 Jul 2021 11:26

Last Modified:

01 Aug 2021 03:00

Publisher DOI:

10.3389/fped.2021.667507

PubMed ID:

34123970

Uncontrolled Keywords:

COVID-19 Kawasaki disease MIS-C child multisystem inflammatory syndrome pediatric inflammatory multisystem syndrome septic shock

BORIS DOI:

10.48350/157804

URI:

https://boris.unibe.ch/id/eprint/157804

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