A national consensus management pathway for paediatric inflammatory multisystem syndrome temporally associated with COVID-19 (PIMS-TS): results of a national Delphi process


Harwood, Rachel ORCID: 0000-0003-3440-3142, Allin, Benjamin, Jones, Christine E, Whittaker, Elizabeth, Ramnarayan, Padmanabhan, Ramanan, Athimalaipet V, Kaleem, Musa, Tulloh, Robert, Peters, Mark J, Almond, Sarah et al (show 6 more authors) (2021) A national consensus management pathway for paediatric inflammatory multisystem syndrome temporally associated with COVID-19 (PIMS-TS): results of a national Delphi process LANCET CHILD & ADOLESCENT HEALTH, 5 (2). pp. 133-141. ISSN 2352-4642, 2352-4642

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Abstract

Paediatric inflammatory multisystem syndrome temporally associated with COVID-19 (PIMS-TS) is a novel condition that was first reported in April, 2020. We aimed to develop a national consensus management pathway for the UK to provide guidance for clinicians caring for children with PIMS-TS. A three-phase online Delphi process and virtual consensus meeting sought consensus over the investigation, management, and research priorities from multidisciplinary clinicians caring for children with PIMS-TS. We used 140 consensus statements to derive a consensus management pathway that describes the initial investigation of children with suspected PIMS-TS, including blood markers to help determine the severity of disease, an echocardiogram, and a viral and septic screen to exclude other infectious causes of illness. The importance of a multidisciplinary team in decision making for children with PIMS-TS is highlighted throughout the guidance, along with the recommended treatment options, including supportive care, intravenous immunoglobulin, methylprednisolone, and biological therapies. These include IL-1 antagonists (eg, anakinra), IL-6 receptor blockers (eg, tocilizumab), and anti-TNF agents (eg, infliximab) for children with Kawasaki disease-like phenotype and non-specific presentations. Use of a rapid online Delphi process has made it possible to generate a national consensus pathway in a timely and cost-efficient manner in the middle of a global pandemic. The consensus statements represent the views of UK clinicians and are applicable to children in the UK suspected of having PIMS-TS. Future evidence will inform updates to this guidance, which in the interim provides a solid framework to support clinicians caring for children with PIMS-TS. This process has directly informed new PIMS-TS specific treatment groups as part of the adaptive UK RECOVERY trial protocol, which is the first formal randomised controlled trial of therapies for PIMS-TS globally.

Item Type: Article
Uncontrolled Keywords: PIMS-TS National Consensus Management Study Group, Humans, Interdisciplinary Communication, Child, Critical Pathways, Disease Management, Systemic Inflammatory Response Syndrome, United Kingdom, COVID-19
Depositing User: Symplectic Admin
Date Deposited: 09 Oct 2020 08:13
Last Modified: 16 Jun 2026 07:45
DOI: 10.1016/S2352-4642(20)30304-7
Open Access URL: https://doi.org/10.1016/S2352-4642(20)30304-7
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URI: https://livrepository.liverpool.ac.uk/id/eprint/3103907
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