Conjunctivitis may be the presenting sign of pediatric infla
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The authors described the characteristics of hospitalized children who developed pediatric inflammatory multisystem syndrome temporally associated with COVID-19 (PIMS-TS).

Of 58 children who met the criteria for pediatric inflammatory multisystem syndrome temporally associated with COVID-19, 45 (78%) had evidence of current or prior COVID-19 infection. All children presented with fever and nonspecific symptoms, including conjunctival injection (45%), rash (52%), vomiting (45%), abdominal pain (53%) and diarrhea (52%). Twenty-nine developed shock and required inotropic support and fluid resuscitation, including 79% of the subgroup receiving mechanical ventilation.

Thirteen patients met the American Heart Association's definition of KD, and 23 had fever and inflammation without features of shock or Kawasaki disease. Eight patients (14%) developed coronary artery dilatation or aneurysm. Children with pediatric inflammatory multisystem syndrome temporally associated with COVID-19 tended to be older than those with Kawasaki disease or Kawasaki disease shock syndrome (median age 9 years vs. 2.7 years and 3.8 years, respectively) and had higher white blood cell count, neutrophil count, fibrinogen levels, troponin levels and C-reactive protein, as well as more profound lymphopenia and anemia and lower platelet counts.

Clinical significance
These findings help characterize the clinical features of seriously ill children with pediatric inflammatory multisystem syndrome temporally associated with COVID-19 and provide insights into this apparently novel syndrome. There is a wide spectrum of presenting signs and symptoms and disease severity, ranging from fever, inflammation and conjunctivitis to myocardial injury, shock and development of coronary artery aneurysms. The comparison with patients with KD and KD shock syndrome provides insights into this syndrome, and suggests this disorder differs from other pediatric inflammatory entities.

Source: https://www.aao.org/editors-choice/conjunctivitis-may-be-presenting-sign-of-pediatric
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