RCPCH responds to reporting on numbers of cases Paediatric Multisystem Inflammatory Syndrome (PIMS)

Dr Liz Whittaker, RCPCH infectious disease lead, said:

It is important to contextualise any reported numbers. Internationally, we have seen that only around 1 in 5,000 of those children infected with COVID will go on to develop PIMS. PIMS is a spectrum which includes children who have high fever and inflammation, to children who have severe shock, requiring support in a high dependency unit or intensive care unit.

In the UK, we believe the peak of admissions to have been last week and that in most parts of the country numbers are now falling. At the peak, 12-15 children a day in the UK were admitted to hospital for a few days. Over 60% of these did not have severe PIMS.

During December, in anticipation of increased numbers of these children, we prepared our teams to look after any children with suspected cases of PIMS – with reminders of symptoms to look out for, diagnostic tests and information about treatment. In addition, we had conversations with colleagues in Paediatric Intensive Care Units to ensure that if we needed ITU beds, these would be available. In fact, we have not needed as many as we feared, partly because the children are recognised early and we have been able to start treatment promptly. There is no sign that the new variant has led to more severe disease, or increased numbers, thank goodness.

Unfortunately, more children from some ethnic backgrounds seem to be disproportionately affected by PIMS. Around the world, over 50% of these - but far fewer than 75% - are from a non-white background. There may be a genetic component, but we think it is more likely that this reflects a higher incidence of COVID in these groups within the general population. Inequalities in our society continue to mean that some people are more likely to be exposed to infection with COVID.