100 Australian children hospitalized with rare post-Covid disease

More Australian children have been diagnosed with a rare but life-threatening post-Covid disease this year than the previous two years combined.

More than 100 children in Australia have been hospitalized with a rare but serious illness weeks after having Covid, with some ending up in intensive care.

Some of the children weren’t even sick when they initially had Covid.

In the first two years of the pandemic, 35 patients were treated for pediatric inflammatory multisystem syndrome (PIMS-TS) associated with Covid.

In the first four months of this year alone, that number more than doubled to 72, according to data provided to news.com.au by the Federal Department of Health.

PIMS-TS is a rare syndrome where different parts of the body become inflamed, usually between two and six weeks after having Covid.

Less than 0.5% of children worldwide who have had Covid have developed the disease and all patients in Australia are thought to have recovered.

But Dr Catherine McAdam says it is a frightening experience for the child and family, and even when they leave hospital it can be a stressful time.

Dr McAdam is the Head of General Paediatrics at Monash Children’s Hospital in Melbourne, where Australia’s first PIMS-TS patient was treated in August 2020.

The hospital has now treated 28 children, most staying between three and seven days.

“All of them made a full recovery, however (the parents) lived with this anxiety for four to six weeks after ‘will my child be the first to have a long-term complication?'” she said at news.com.au.

Dr McAdam also said patients should be discharged daily on medications such as aspirin to prevent blood clots and should return to hospital for follow-up appointments.

While the children were sick enough to be hospitalized, the severity of the illness varied.

“The case in our intensive care unit needed certain medications to support heart pumping,” said Dr McAdam, who was one of the most severe cases.

Interestingly, the severity of the child’s Covid infection does not predict the severity of PIMS-TS.

“Sometimes they don’t know they had Covid…they never developed symptoms with their Covid infection but did develop it a few weeks later,” she explained.

What is the disease?

It is not yet known why some children develop PIMS-TS after Covid.

In the United States, where some children have died, the syndrome is called multisystem inflammatory syndrome in children (MIS-C).

Children are affected differently by PIMS-TS, but the main symptoms include fever for several days, stomach pain, diarrhea, vomiting, tightness/chest pain, extreme fatigue, skin rash , cold hands and red eyes.

“There seem to be sort of two variations,” Dr. McAdam said.

“Another abdominal pain, diarrhea and intestinal symptoms, and the other more skin, fever, inflammation.”

She explained that sometimes the patient is hospitalized for a few days before the PIMS-TS is confirmed.

Associate Professor Shidan Tosif told the sun herald the syndrome was ‘very rare’ but was the most significant complication of SARS Covid infection in children.

Dr Tosif is the Covid clinical director at the Royal Children’s Hospital in Melbourne, which has treated 29 patients, including children in intensive care.

“In some cases (there is) a more severe presentation with what we call shock, where they are actually sicker, have more severe pain, difficulty maintaining blood pressure and an altered state of consciousness” , did he declare.

“It poses a potential risk to the heart and other organs and that’s why it’s important to recognize it and treat it early.”

PIMS-TS cases in Australia

Data from the Pediatric Active Enhanced Disease Surveillance (PAEDS) network – eight hospital sites in Australia monitoring PIMS-TS – shows that the median age of a child with the disease is eight years old.

The youngest patient was only three months old and the oldest was 15 years old.

A panel of experts reviews each case in Australia.

While the latest data shows there were 107 cases through the end of April, the number is now higher.

Dr Tosif said his hospital had seen more cases this year compared to all of last year, which he said ‘reflects the omicron surge we have seen’.

Dr McAdam agreed that an increase in Covid cases had led to an increase in PIMS-TS cases.

“When we had lockdowns and very little (Covid) infection in the community we didn’t see that very often and then when things opened up late last year we started to seeing a lot more…in February I was seeing two to three cases (PIMS-TS) a week,” she said.

What role does the Covid vaccination play?

Dr McAdam said his hospital had seen fewer cases of PIMS-TS as more children were vaccinated against Covid.

Australian children aged 5 to 11 could receive their first dose from January 10.

“Vaccination works,” she said, also encouraging the flu shot.

“I suspect what we can see is that the mean or median age of PIMS-TS is going down because we don’t have a vaccine available for under-fives yet.”

Dr. Tosif also said vaccination helps reduce the risk of children developing PIMS-TS.

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