A comparison of pediatric inflammatory multisystem syndrome temporarily-associated with SARS-CoV-2 and Kawasaki disease
Authors: Hufnagel Markus , Armann Jakob , Jakob André , Doenhardt Maren , Diffloth Natalie , Hospach Anton , Schneider Dominik T. , Trotter Andreas , Roessler Martin , Schmitt Jochen , Berner Reinhard ,   The PIMS-DGPI Working Group, Adamiak-Brych Grazyna , Aderhold Martina , Aggar Sara , Ahmed Mohammed-Ahmed , Akanbi Sandra , Anders Kristin , Arens Stefan , Armann Jakob , Baßmann Christoph , Baumbach Lisa , Bayrhof Otto-Jonas , Beier Gerald , Berger Ardua , Bernard Daniel , Berner Reinhard , Berwald Mario , Biering Adina , Blümlein Ulrike , Blume Stefanie , Böckenholt Kai , Bölke Carsten , Boesing Thomas , Bonacker Robert , Borchers Monika-Maria , Brenner Britta , Brinkmann Folke , Brühler Jasmin , Brunner Jürgen , Buchtala Laura , Budde Jörg , Bullmann Reinhard , Schoppe Marc Carré , Cvetanovic Gordana , Czwienzek Alina , Degirmenci Metin , Dejas Fenja , Demirdelen Bergüzar , Diederichs Anke , Dittrich Maren , Döhring Katharina , Donath Helena , Ebert Franziska , Eff Annemarie , Ehrentraut Kerstin , Eißler Fiene , Eißner Anne , Endres Elisa , Engler Matthias , Fiedler Andreas , Fingerhut Karin , Finster Agnes , Fischer Doris , Flümann Simon , Foth Svenja , Fremery Christian , Frenzke Holger , Galow Lukas , Gappa Monika , Gerling Stephan , Gitzinger Stina , Glaser Nicola , Goj Karoline , Goretzki Sarah Christina , Gröger Katrin , Groteclaes Tim , Grüner Judith , Grünwedel Mike , Haag Stephan , Hacker Lisa , Halwas Nikolaus , Hanke Christof , Haupt Anne , Heinrich Christina , Heinrich Julia , Hempel Lutz , Hermann Matthias , Herzog Matthias , Heubner Georg , Hillebrand Georg , Himpel Matthias , Hilker Kai-Alexandra , Hittmeyer Cara , Höche Alexander , Höfgen Mirjam , Höpner Uwe , Holtkamp Katharina , Hoppen Thomas , Horstkemper Marita , Horstmann Judith , Hospach Anton , Hufnagel Markus , Ido Nora , Iliaev Vladimir , Ioannou Phryne , Jakob André , Jantzen Dirk , Jenssen Söhnke , Jung Claudia , Kaiser-Labusch Petra , Kalhoff Herrmann , Keck Johanna , Kelch Felicitas , Keller Thomas , Kelzon Svetlana , Kern Jan , Keßner Marie-Sophie , Kever Daniel , Kirchner Arni , Kirschstein Martin , Kitz Richard , Klauwer Dietrich , Kleff Christine , Kluthe Christof , Knechtel Jan , Knop Lisanne , Köster Holger , Vasconcelos Malte Kohns , Konrad Florian , Kosteczka Robert , Koukli Georgia , Kowski Sascha , Kuhnigk Mirco , Kuska Marion , Kwaschnowitz Sachicko , Lange Veit , Lautner Gerrit , Libuschewski Hanna , Liese Johannes , Lindemann Linus , Lorenz Norbert , Lorenzen Niko , Lubitz Daniela , Machata Heike , Mader Franziska , Malath Ingrid , Mampe Cornelie , Markowsky Andrea , Mauritz Maximilian , Meister Jochen , Menden Melanie , Menzel Felix , Merker Michael , Meyer Jens , Meyer-Dobkowitz Lars , Mohorovicic Marko , Moise Laura Gabriela , Morawski Yvonne , Motzkus Laura , Müller Bianca , Müller Guido , Müller Mirja , Müller Meike , Niehaus Thomas , Oberthür Andre , Ohlendorf Johanna , Olar Florina , Opgen-Rhein Bernd , Östreicher Iris , Parthey Kathlee , Pentek Falk , Pötzsch Simone , Ponsa Corinna , Rambow Jenny , Reck Heike , Reichert Friedrich , Reil Annika , Reinhardt Thomas , Richter Carolin , Richter Jost Wigand , Rieber Nikolaus , Ringe Hannelore , Rühlmann Alexander , Samol Anja , Sauerbrey Kristin , Schäfer Miriam , Schaeffer Nico , Scheffler Miriam , Schlick Christian , Schmitt Caroline , Schneider Dominik , Schneider Hans-Christoph , Schnelke Alexander , Schrewe Roland , Schrod Lothar , Schroers Oliver , Schütz Katharina , Schulteß Leonie , Schumacher Isabel , Seidel Sabrina , Simon Arne , Soditt Volker , Sönmez Ezgi , Spancken Elena , Spath Lisa , Spinner Sebastian , Stastny Barbara , Steidl Michael , Steif Benedikt , Steimer Ann-Kathrin , Stemberg Frank , Stockmann Antje , Stöhring Thomas , Sumbadze Daria , Teichmann Axel , Thiel Lion , Tränkner Jan , Trau Stefanie , Treichel Tina , Trotter Andreas , van den Heuvel Alijda , Vehse Kai , Vischer Lena , Wahjudi Tatjana , Waldecker Karin , Walden Ulrike , Warneke Laura , Weber Sarah , Wehl Götz , Wehrhoff Falk , Weigert Alexander , Wenzel Sandra , Werner Annika , Weste Clarissa , Wichmann Barbara , Wild Florian , Willmer Denise , Wolf Felicitas , Wrenger Nina , Wurm Donald , Yussif Anne-Sophie , Zeißig Yvonne , Zügge Ulrich 
Published: January 2023

The connection between Pediatric Inflammatory Multisystem Syndrome (PIMS) and Kawasaki Disease (KD) is not yet fully understood. Using the same national registry, clinical features and outcome of children hospitalized in Germany, and Innsbruck (Austria) were compared. Reported to the registry were 395 PIMS and 69 KD hospitalized patients. Patient age in PIMS cases was higher than in KD cases (median 7 [IQR 4–11] vs. 3 [IQR 1–4] years). A majority of both PIMS and KD patients were male and without comorbidities. PIMS patients more frequently presented with organ dysfunction, with the gastrointestinal (80%), cardiovascular (74%), and respiratory (52%) systems being most commonly affected. By contrast, KD patients more often displayed dermatological (99% vs. 68%) and mucosal changes (94% vs. 64%), plus cervical lymph node swelling (51% vs. 34%). Intensive care admission (48% vs. 19%), pulmonary support (32% vs. 10%), and use of inotropes/vasodilators (28% vs. 3%) were higher among PIMS cases. No patients died. Upon patient discharge, potentially irreversible sequelae—mainly cardiovascular—were reported (7% PIMS vs. 12% KD). Despite differences in age distribution and disease severity, PIMS and KD cases shared many common clinical and prognostic characteristics. This supports the hypothesis that the two entities represent a syndrome continuum.