Pediatric Inflammatory Multisystem Syndrome Tied to Ongoing Otolaryngologic Problems

By Reuters Staff

March 04, 2021

NEW YORK (Reuters Health) - Pediatric inflammatory multisystem syndrome temporally associated with COVID-19 disease (PIMS-TS) is associated with a variety of disorders affecting voice, swallowing and smell and taste, which may be long-lasting, according to researchers based in the U.K.

In a letter in JAMA Otolaryngology-Head and Neck Surgery, Dr. Ryan C. T. Cheong of Great Ormond Street Hospital for Children NHS Trust, in London, and colleagues report on their experience with children 18 years or younger presenting with PIMS-TS.

A total of 50 children with a median age of 10 years were enrolled. Two-thirds were male and most (72%) were of Black, Asian or other minority race or ethnicity. The median time from presentation to follow-up was 60 days.

Twenty-four percent had positive results from polymerase chain reaction tests for SARS-CoV-2. Serology testing showed that 84% had positive immunoglobulin G antibodies against SARS-CoV-2.

Three-quarters required admission to a pediatric intensive-care unit and 36% required intubation for mechanical ventilation. Among the most prevalent conditions encountered were nasal obstruction and rhinorrhea, dysphagia and dysphonia, pharyngitis and tonsillitis as well as dyspnea and conjunctivitis.

On telephone follow-up screening, it was found that 38% of the patients required further in-person follow-up with an otolaryngologist. The otolaryngologic manifestations most commonly seen at follow-up were dysphonia, dysphagia and anosmia/hyposmia. These were seen in 30% of the children at this point and had been significantly present during acute PIMS-TS presentation in 8% of children.

"Further studies are required to identify patient- and disease-associated factors, such as race/ethnicity or need for intubation, that may increase the risk of persistent otolaryngologic sequelae," the authors write.

"Because the long-term sequelae of this disease are unknown," they add, "it is prudent for children with a history of PIMS-TS to be reevaluated by the infectious diseases team within 12 months and referred to otolaryngology for any persistent symptoms."

Dr. Cheong did not respond to requests for comments.

SOURCE: JAMA Otolaryngology-Head & Neck Surgery, online February 25, 2021.