Thread by @MJGriksaitis

Prof Mike Levin talking to us about the #physiology and #immunology of #COVID19 and #PIMSTS in #PedsICU

Generally children had a mild disease phenotype - then as the pandemic progressed more inflammatory disorders were seen and a new condition was created: PIMS-TS

#EPCCS20

Further investigation of the #COVID19 inflammatory response found 3 phenotypes - all had coronary artery disease, but not all needed #PedsICU

#EPCCS20

The new disease when compared to Kawasaki disease:
- higher CRP
- younger age
- higher ferritin
- lower lympocytes
- lower albumin
- lower haemoglobin

Shock patients:
- higher troponin
- higher BNP
- higher CRP

#PedsICU #COVID19 #EPCCS20

So why does #PIMSTS happen?

Perhaps it’s an acquired immune response to #COVID19 - but many had significant activation of neutrophils and some sequences had similarities to toxic shock syndrome

Many questions are still unanswered says Prof Levin

#PedsICU #EPCCS20

Those with the inflammatory disease #PIMSTS have strikingly higher cytokines that simple #COVID19 patients

Those with #PIMSTS have a higher immunoglobulin response too...

#PedsICU #EPCC20 #immunology

Those with #PIMSTS also seem to have less neutralising antibodies than those with severe #COVID19

#PedsICU #EPCCS20

So Prof Levin concludes saying more research is needed and to enrol these #PIMSTS children into relevant studies to help us further understand all this #immunology

#PedsICU #EPCCS20