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One-Year Outcomes of Critical Care Patients Post–COVID-19 Multisystem Inflammatory Syndrome in Children

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

Medium- to long-term outcomes of the novel pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS)1 or multisystem inflammatory syndrome in children (MIS-C) are unknown. Short-term, 40-day, and 6-month outcomes have been published previously.25

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Article Information

Accepted for Publication: June 17, 2021.

Published Online: August 30, 2021. doi:10.1001/jamapediatrics.2021.2993

Corresponding Author: Patrick Davies, MRCPCH, Paediatric Critical Care Unit, Nottingham Children’s Hospital, Derby Road, Nottingham NG7 2UH, United Kingdom (patrick.davies@nuh.nhs.uk).

Author Contributions: Dr Davies had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Davies, du Pré, Kanthimathinathan.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Davies, du Pré.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Davies.

Administrative, technical, or material support: Davies, Lillie.

Other—suggestions re: analysis and presentation of data: Kanthimathinathan.

Conflict of Interest Disclosures: None reported.

Additional Contributions: We acknowledge the contribution and collaboration of the following in the collection of this data, and for the creation of the initial cohort: Claire Evans, MRCPCH, Andrew Prayle, PhD, and Harish Vyas, DM, Paediatric Critical Care Unit, Nottingham Children’s Hospital, Nottingham, UK; Joseph Brierley, MRCPCH, and Mae Johnson, FRCA, Paediatric Intensive Care Unit, Great Ormond Street Hospital, London, UK; Gareth Waters, FRCA, and Benedict Griffiths, MBBS, Paediatric Intensive Care Unit, Evelina Children’s Hospital, London, UK; Zoha Mohammad, MRCPCH, Paediatric Intensive Care Unit, Leicester Royal Infirmary, Leicester, UK; Akash Deep, MRCPCH, Paediatric Intensive Care Unit, King’s College Hospital, London, UK; Stephen Playfor, DM, Paediatric Intensive Care Unit, Royal Manchester Children’s Hospital, Manchester, UK; Davinder Singh, MRCPCH, Paediatric Intensive Care Unit, Leeds Royal Infirmary, Leeds, UK; David Inwald, PhD, Paediatric Intensive Care Unit, Addenbrooke’s Hospital, Cambridge, UK; Michelle Jardine, MSc, Paediatric Critical Care Unit, Children’s Hospital for Wales, Cardiff, UK; Oliver Ross, FRCA, Paediatric Intensive Care Unit, Southampton Children’s Hospital, Southampton, UK; Nayan Shetty, MRCPCH, Paediatric Intensive Care Unit, Alder Hey Children’s Hospital, Liverpool, UK; Mark Worrall, MBChB, Paediatric Intensive Care Unit, Royal Hospital for Children, Glasgow, UK; Ruchi Sinha, MRCPCH, Paediatric Intensive Care Unit, St Mary’s Hospital, London, UK; Ashwani Koul, DNB(MD), Paediatric Critical Care Unit, John Radcliffe Hospital, Oxford, UK; Elizabeth Whittaker, PhD, Paediatric Infectious Diseases Department, Imperial College Healthcare NHS Trust, London UK; Barnaby R. Scholefield, PhD, Paediatric Intensive Care Unit, Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK and Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK; Padmanabhan Ramnarayan, Children’s Acute Transport Service, Great Ormond Street Hospital NHS Foundation Trust and NIHR Biomedical Research Centre, London, UK.

References
1.
Whittaker  E , Bamford  A , Kenny  J ,  et al; PIMS-TS Study Group and EUCLIDS and PERFORM Consortia.  Clinical characteristics of 58 children with a pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2.   JAMA. 2020;324(3):259-269. doi:10.1001/jama.2020.10369PubMedGoogle ScholarCrossref
2.
Davies  P , Lillie  J , Prayle  A ,  et al.  Association between treatments and short-term biochemical improvements and clinical outcomes in post-severe acute respiratory syndrome coronavirus-2 inflammatory syndrome.   Pediatr Crit Care Med. 2021;22(5):e285-e293. doi:10.1097/PCC.0000000000002728PubMedGoogle ScholarCrossref
3.
Abrams  JY , Oster  ME , Godfred-Cato  SE ,  et al.  Factors linked to severe outcomes in multisystem inflammatory syndrome in children (MIS-C) in the USA: a retrospective surveillance study.   Lancet Child Adolesc Health. 2021;5(5):323-331. doi:10.1016/S2352-4642(21)00050-XPubMedGoogle ScholarCrossref
4.
Feldstein  LR , Tenforde  MW , Friedman  KG ,  et al; Overcoming COVID-19 Investigators.  Characteristics and outcomes of US children and adolescents with multisystem inflammatory syndrome in children (MIS-C) compared with severe acute COVID-19.   JAMA. 2021;325(11):1074-1087. doi:10.1001/jama.2021.2091PubMedGoogle ScholarCrossref
5.
Penner  J , Abdel-Mannan  O , Grant  K ,  et al; GOSH PIMS-TS MDT Group.  6-Month multidisciplinary follow-up and outcomes of patients with paediatric inflammatory multisystem syndrome (PIMS-TS) at a UK tertiary paediatric hospital: a retrospective cohort study.   Lancet Child Adolesc Health. 2021;5(7):473-482. doi:10.1016/S2352-4642(21)00138-3PubMedGoogle ScholarCrossref
6.
Davies  P , Evans  C , Kanthimathinathan  HK ,  et al.  Intensive care admissions of children with paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) in the UK: a multicentre observational study.   Lancet Child Adolesc Health. 2020;4(9):669-677. doi:10.1016/S2352-4642(20)30215-7PubMedGoogle ScholarCrossref
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 credit toward the CME [and Self-Assessment requirements] of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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