In infected children there are often no symptoms - but consequences if they have the Sars-CoV-2 infection behind them (symbol picture)
Photo: Daniel Reinhardt / dpa
The coronavirus usually passes children and adolescents by without any serious symptoms or illness at all.
But pediatricians have been alarmed for some time.
Because a new type of syndrome affects some children - for weeks after they have had a Sars-CoV-2 infection.
The long-term consequences are accompanied by violent inflammatory reactions in various organs due to a misdirected immune system, fortunately it only occurs very rarely.
In Germany, only one in a thousand infected children is affected.
But Pims, an abbreviation for "Pediatric Inflammatory Multisystem Syndrome," usually hits those affected badly.
Often these children are then in hospital with a variety of complaints.
There were deaths related to the disease in the United States last year.
There, doctors from the Centers for Disease Control and Prevention (CDC), an agency of the US Department of Health, have now presented a comprehensive study on MIS-C (Multisystem Inflammatory Syndrome in Children), as the disease is called there.
The work confirms what has already been indicated: Most children who get pimps show no symptoms after a previous infection with Sars-CoV-2.
According to the study, which has now been published in the journal »JAMA Pediatrics«, around three quarters of a group of more than 1000 children and adolescents examined had no typical Covid-19 symptoms before their Pims disease.
Out of 1075 patients for whom data were available, only 265 had typical symptoms.
The asymptomatic children were usually younger, on average about eight years old, while the average age of the others was eleven years.
However, the younger children may not express themselves as often about their complaints, the researchers suspect.
All children examined in the study were treated in clinics, more than half in intensive care units.
They fell ill about two to five weeks after a corona infection.
"We assume that most illnesses result from an asymptomatic or mild Covid-19 illness," writes the team led by Ermias Belay from the CDC's Covid-19 Response Team.
It is not yet clear why the children's bodies react in this way.
Presumably it is a delayed immunological response.
The inflammatory reactions appear to occur when antibody production against Sars-CoV-2 is at its peak, the researchers write.
Of the more than 2000 Pims cases reported to the CDC, the study examined around 1700 from March 2020 to January 2021 (information on Covid symptoms was only available for 1075).
90 percent of the children suffered from health problems that affected at least four organs.
The heart was particularly affected.
The complaints included inflammation of the heart muscle, low blood pressure or disorders of the heart function, which prevented the patient from pumping properly.
Young patients in particular who had no Covid 19 symptoms experienced such severe courses with heart problems.
However, toddlers under five years of age do not suffer from severe pims courses as often.
Children who were ten years or older were more likely to be affected.
A total of 24 deaths were recorded in the United States.
No information was available on previous illnesses.
The gastrointestinal tract was also affected in many.
Two thirds suffered from vomiting, stomach pain or diarrhea.
There was also a respiratory problem, fever and a rash.
For pediatricians, the fact that children and adolescents in particular who had shown no or only a few Covid symptoms seem to be more seriously ill make their work more difficult.
The study showed a clear correlation in the accumulation of cases with the respective corona waves in the USA.
Two pims waves can be seen that were recorded a few weeks after the rise in Sars-CoV-2 cases.
So if the total number of cases increases, parents and doctors should be made aware of Pims symptoms.
According to figures from the German Society for Pediatric Infectious Diseases (DGPI), there are currently 260 known cases of Pims in children and adolescents in Germany.
Here, too, there was a correlation with the corona waves with a time delay.
"There is a Pims disease peak at the end of December 2020, which occurred parallel to the peak of Covid-19 hospitalization in children and adolescents," writes the DGPI.
Children with pims are usually older and more male.
After all, the disease can be treated relatively well.
It is partly similar to what is known as Kawasaki syndrome, a rare inflammatory disease that mainly affects children under the age of five.
Antibiotic therapies are carried out against pims, for example.
Cortisone and preparations made from donor blood plasma also help well.
So far, after discharge from the hospital, consequential damage has remained in around ten percent of cases.
Fatal courses have not yet been reported in this country.
However, the DGPI describes a problem that could negatively affect the course of the disease.
Because Pims is apparently mostly not recognized.
According to the DGPI, the diagnosis of admission was different in most cases.