Endothelial function in children with history of Paediatric Inflammatory Multisystem Syndrome - PIMS, following infection with COVID 19
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Acute SARS-CoV-2 infection is generally mild in children, but post-infectious complications, such as pediatric inflammatory multisystem syndrome (PIMS), can be more severe. This study aims to assess endothelial function in children recovered from PIMS. A prospective observational study was conducted, including 17 children diagnosed with PIMS. Endothelial function was evaluated at least 3 months post-diagnosis using endothelin levels and peripheral arterial tonometry (EndoPAT™) to measure Reactive Hyperemia Index (RHI). Endothelial function was assessed at an average of 393±260 days post-PIMS. Endothelin levels were abnormal in 6/15 (40%) patients and correlated with hospitalization duration (r=-0.685, p=0.002), platelet count (r=-0.685, p=0.002), ferritin (r=-0.494, p=0.044), alanine transaminase (ALT), and albumin levels (r=-0.658, p=0.004). Then, using an EndoPAT™ device, endothelial function was compared between the subjects and a control group of 18 healthy children with similar BMI and sex distribution but differing in mean age (11.8±1.04 vs. 14.8±2.2 years, respectively, p=0.049). Mean LNRHI was comparable between groups (0.44±0.34 vs. 0.45±0.23), with no correlation to clinical or laboratory features but positive correlation between time elapsed since PIMS diagnosis. These findings suggest persistent endothelial dysfunction in PIMS survivors correlates with disease severity. Further research is needed to understand the long-term vascular implications.
