Table 2.
Clinical symptoms and significant laboratory values in patients with PIMS-all, PIMS-non-KD, PIMS-KD and KD.
| PIMS-all (n = 395) | PIMS-non-KD (n = 153) | PIMS-KD (n = 242) | p-valuea (95% CI) | KD (n = 69) | p-valueb (95% CI) | |
|---|---|---|---|---|---|---|
| Ear-nose-throat (ENT), n (%) | 119 (30.1) | n.sh | n.sh | n.sh | 32 (46.4) | 0.010 (− 28.2 to 4.3) |
| Respiratory, n (%) | 204 (51.6) | 80 (52.3) | 124 (51.2) | 0.840 (− 11.2 to 9.1) | 23 (33.3) | < 0.001 (5.6–31.0) |
| Dyspnea, n (%) | 44 (11.1) | 26 (17.0) | 18 (7.4) | < 0.001 (− 15.9 to 3.2) | 4 (5.8) | 0.180 (− 2.5 to 13.2) |
| Tachypnea, n (%) | 85 (21.5) | 47 (30.7) | 38 (15.7) | < 0.001 (− 23.2 to 6.8) | 7 (10.1) | 0.030 (1.2–21.6) |
| Pleural effusion, n (%) | 116 (29.4) | 40 (26.1) | 76 (31.4) | 0.260 (− 4.0 to 14.5) | 8 (11.6) | < 0.001 (6.5–29.0) |
| Pneumonia, n (%) | 63 (15.9) | 34 (22.2) | 29 (12.0) | 0.010 (− 17.6 to 2.9) | 5 (7.2) | 0.060 (− 0.3 to 17.8) |
| Pediatric acute respiratory distress syndrome (pARDS), n (%) | 32 (8.1) | 21 (13.7) | 11 (4.5) | < 0.001 (− 14.7 to 3.7) | 1 (1.4) | 0.050 (0.1 to 13.2) |
| Cardiovascular, n (%) | 294 (74.4) | 108 (70.6) | 186 (76.9) | 0.160 (− 2.6 to 15.1) | 42 (60.9) | 0.020 (2.1–25.0) |
| Heart failure, n (%) | 110 (27.8) | 41 (26.8) | 69 (28.5) | 0.710 (− 7.4 to 10.8) | 4 (5.8) | < 0.001 (11.2–32.9) |
| Arterial hypotension, n (%) | 84 (21.3) | 30 (19.6) | 54 (22.3) | 0.520 (− 5.6 to 11.0) | 4 (5.8) | < 0.001 (5.5–25.4) |
| Pericardial effusion, n (%) | 134 (33.9) | 50 (32.7) | 84 (34.7) | 0.680 (− 7.6 to 11.7) | 15 (21.7) | 0.050 (0.2–24.1) |
| Myocardial dysfunction, n (%) | 161 (40.8) | 62 (40.5) | 99 (40.9) | 0.940 (− 9.6 to 10.4) | 8 (11.6) | < 0.001 (17.1–41.2) |
| Peri-/Myocarditis, n (%) | 101 (25.6) | 41 (26.8) | 60 (24.8) | 0.660 (− 10.9 to 6.9) | 5 (7.2) | < 0.001 (7.7–29.0) |
| Coronary artery dilatation, n (%) | 44 (11.1) | 13 (8.5) | 31 (12.8) | 0.190 (− 2.1 to 10.7) | 18 (26.1) | < 0.001 (− 23.6 to 6.3) |
| Coronary aneurysm, n (%) | 37 (9.4) | 11 (7.2) | 26 (10.7) | 0.430 (− 2.4 to 9.5) | 13 (18.8) | 0.020 (− 17.4 to 1.6) |
| Gastrointestinal, n (%) | 316 (80.0) | 116 (75.8) | 200 (82.6) | 0.100 (− 1.3 to 14.9) | 40 (58.0) | < 0.001 (11.4–32.7) |
| Abdominal pain, n (%) | 165 (41.8) | 67 (43.8) | 98 (40.5) | 0.520 (− 13.3 to 6.7) | 20 (29.0) | 0.050 (0.3–25.3) |
| Vomiting, n (%) | 151 (38.2) | 49 (32.0) | 102 (42.1) | 0.040 (0.3–20.0) | 26 (37.7) | 0.930 (− 11.9 to 13.0) |
| Diarrhea, n (%) | 174 (44.1) | 61 (39.9) | 113 (46.7) | 0.180 (− 3.3 to 16.9) | 27 (39.1) | 0.450 (− 7.8 to 17.6) |
| Ascites, n (%) | 126 (31.9) | 44 (28.8) | 82 (33.9) | 0.290 (− 4.3 to 14.6) | 12 (17.4) | 0.010 (2.8–26.2) |
| Gastroenteritis | 75 (19.0) | 22 (14.4) | 53 (21.9) | 0.060 (− 0.4 to 15.5) | 9 (13.0) | 0.240 (− 3.9 to 15.8) |
| Appendicitis, n (%) | 27 (6.8) | 15 (9.8) | 12 (5.0) | 0.060 (− 10.0 to 0.3) | 3 (4.3) | 0.440 (− 3.8 to 8.8) |
| Peritonitis, n (%) | 22 (5.6) | 11 (7.2) | 11 (4.5) | 0.270 (− 7.3 to 2.0) | 1 (1.4) | 0.150 (− 1.4 to 9.7) |
| Thickening of enteric wall, n (%) | 76 (19.2) | 40 (26.1) | 36 (14.9) | 0.010 (− 19.2 to 3.3) | 2 (2.9) | < 0.001 (6.8–25.8) |
| Splenomegaly, n (%) | 68 (17.2) | 19 (12.4) | 49 (20.2) | 0.040 (0.2–15.5) | 9 (13.0) | 0.390 (− 5.4 to 13.7) |
| Hepatic, (%) | 82 (20.8) | 26 (17.0) | 56 (23.1) | 0.140 (− 2.1 to 14.4) | 13 (18.8) | 0.720 (− 8.4 to 12.3) |
| Hepatomegaly, n (%) | 64 (16.2) | 15 (9.8) | 49 (20.2) | 0.010 (3.0–17.9) | 11 (15.9) | 0.960 (− 9.2 to 9.7) |
| Renal, n (%) | 82 (20.8) | 34 (22.2) | 48 (19.8) | 0.570 (− 10.6 to 5.9) | 7 (10.1) | 0.040 (0.5–20.7) |
| Impaired renal function, n (%) | 48 (12.2) | 21 (13.7) | 27 (11.2) | 0.450 (− 9.2 to 4.1) | 2 (2.9) | 0.020 (1.3–17.2) |
| Nephritis, n (%) | 5 (1.3) | 5 (3.3) | 0 | < 0.001 (− 5.5 to 1.0) | 2 (2.9) | 0.310 (− 4.8 to 1.5) |
| Neurological, n (%) | 90 (22.8) | 35 (22.9) | 55 (22.7) | 0.970 (− 8.7 to 8.4) | 8 (11.6) | 0.040 (0.8–21.6) |
| Headache, n (%) | 43 (10.9) | 16 (10.5) | 27 (11.2) | 0.830 (− 5.6 to 7.0) | 4 (5.8) | 0.800 (− 2.6 to 12.8) |
| Meningitis, n (%) | 17 (4.3) | 7 (4.6) | 10 (4.1) | 0.830 (− 4.6 to 3.7) | 1 (1.4) | 0.260 (− 2.1 to 7.8) |
| Psychiatric, n (%) | 15 (3.8) | 5 (3.3) | 10 (4.1) | 0.660 (− 3.0 to 4.8) | 1 (1.4) | 0.330 (− 2.3 to 7.0) |
| Musculoskeletal, n (%) | 40 (10.1) | 14 (9.2) | 26 (10.7) | 0.610 (− 4.5 to 7.7) | 10 (14.5) | 0.280 (− 12.3 to 3.6) |
| Arthralgia, n (%) | 17 (4.3) | 7 (4.6) | 10 (4.1) | 0.830 (− 4.6 to 3.7) | 7 (10.1) | 0.040 (− 11.5 to 0.2) |
| Arthritis, n (%) | 7 (1.8) | 3 (2.0) | 4 (1.7) | 0.820 (− 3.0 to 2.4) | 4 (5.8) | 0.040 (− 7.9 to 0.1) |
| Myalgia, n (%) | 27 (6.8) | 8 (5.2) | 19 (7.9) | 0.320 (− 2.5 to 7.8) | 3 (4.3) | 0.440 (− 3.8 to 8.8) |
| Myositis, n (%) | 4 (1.0) | 2 (1.3) | 2 (0.8) | 0.640 (− 2.5 to 1.6) | 0 | 0.400 (− 1.4 to 3.4) |
| Hematological, n (%) | 152 (38.5) | 54 (35.3) | 98 (40.5) | 0.300 (− 4.7 to 15.1) | 15 (21.7) | 0.010 (4.5–29.0) |
| Anemia, n (%) | 80 (20.3) | 21 (13.7) | 59 (24.4) | 0.010 (2.5–18.8) | 9 (13.0) | 0.160 (− 2.9 to 17.3) |
| Thrombocytopenia, n (%) | 62 (15.7) | 18 (11.8) | 44 (18.2) | 0.090 (− 1.0 to 13.8) | 3 (4.3) | 0.010 (2.5–20.2) |
| Disseminated intravascular coagulation, n (%) | 39 (9.9) | 18 (11.8) | 21 (8.7) | 0.320 (− 9.2 to 3.0) | 0 | 0.010 (2.8–16.9) |
| Cutaneous, n (%) | 269 (68.1) | n.sh | n.sh | n.sh | 68 (98.6) | < 0.001 (− 41.6 to 19.3) |
| Rash, n (%) | 229 (58.0) | n.sh | n.sh | n.sh | 59 (85.5) | < 0.001 (− 29.9 to 12.6) |
| Desquamation, n (%) | 35 (8.9) | n.sh | n.sh | n.sh | 17 (24.6) | < 0.001 (− 23.8 to 7.8) |
| Swelling of hand/feet, n (%) | 117 (29.6) | n.sh | n.sh | n.sh | 37 (53.6) | < 0.001 (− 35.9 to 12.1) |
| Mucosal, n (%) | 254 (64.3) | n.sh | n.sh | n.sh | 65 (94.2) | < 0.001 (− 41.5 to 18.3) |
| Enanthema, n (%) | 151 (38.2) | n.sh | n.sh | n.sh | 47 (68.1) | < 0.001 (− 42.3 to 17.5) |
| Conjunctivitis, n (%) | 226 (57.2) | n.sh | n.sh | n.sh | 60 (87.0) | < 0.001 (− 41.9 to 17.5) |
| Cervical lymphadenopathy, n (%) | 136 (34.4) | n.sh | n.sh | n.sh | 35 (50.7) | 0.010 (− 28.6 to 4.0) |
| Hemoglobin, median in mmol/L, (IQR) | 6.2 (5.6–7.2) | 6.3 (5.6–7.3) | 6.2 (5.5–7.1) | 0.498 (− 0.2 to 0.5) | 6.6 (6.0–7.3) | 0.006 (− 0.4 to − 0.7) |
| Missing values, n (%) | 65 (16.5) | 31 (20.2) | 34 (14.0) | 2 (2.9) | ||
| Thrombocytes, median in per 109/L, (IQR) | 141.0 (95.0–372.0) | 150.5 (91.5–455.2) | 140.0 (95.5–317.5) | 0.556 (− 18.7 to 34.7) | 464.0 (258.0–642.0) | < 0.001 (− 415.8 to − 230.2) |
| Missing values, n (%) | 69 (17.5) | 32 (20.9) | 37 (15.3) | 5 (7.2) | ||
| Leukocytes, median in per 109/L, (IQR) | 12.5 (5.3–19.4) | 12.8 (5.1–19.6) | 12.3 (5.4–19.0) | 0.762 (− 2.7 to 3.7) | 14.8 (6.9–18.0) | 0.202 (− 5.3 to 1.1) |
| Missing values, n (%) | 83 (21.0) | 32 (20.9) | 51 (21.1) | 4 (5.8) | ||
| Neutrophils, median in per 109/L, (IQR) | 6.7 (3.1–12.1) | 7.5 (2.5–12.8) | 6.4 (3.4–11.4) | 0.419 (− 1.5 to 3.7) | 0.91 (0.001–9.8) | 0.002 (2.1–9.0) |
| Missing values, n (%) | 265 (67.1) | 101 (66.0) | 164 (67.8) | 32 (46.4) | ||
| Lymphocytes, median in per 109/L, (IQR) | 0.80 (0.42–2.1) | 0.78 (0.48–1.5) | 0.90 (0.40–2.5) | 0.512 (− 0.5 to 3.7) | 0.50 (0.18–2.5) | 0.564 (− 0.7 to 1.3) |
| Missing values, n (%) | 264 (66.8) | 101 (66.0) | 163 (67.4) | 35 (50.7) | ||
| C-reactive protein, median in mg/L, (IQR) | 187.8 (118.1–253.4) | 174 (119.7–258.5) | 196.5 (116.5–251.8) | 0.075 (− 1.5 to 54.1) | 122 (63.7–176.0) | < 0.001 (35.3–97.7) |
| Missing values, n (%) | 27 (6.8) | 11 (7.2) | 16 (6.6) | 2 (2.9) | ||
| Ferritin, median in ng/mL, (IQR) | 508 (296.8–883.5) | 537 (297.0–839.3) | 485 (295.0–883.5) | 0.322 (− 170.6 to 57.3) | 211.5 (155.9–318.8) | < 0.001 (236.7–379.8) |
| Missing values, n (%) | 115 (29.1) | 45 (29.4) | 70 (28.9) | 29 (42.0) | ||
| NT-proBNP, median in pmol/L, (IQR) | 556 (130.4–1436.5) | 435.1 (101.3–1431.5) | 585.7 (151.9–1434.5) | 0.015 (− 78.4 to 424.7) | 151.4 (52.9–331.8) | < 0.001 (287.5–575.4) |
| Missing values, n (%) | 99 (25.1) | 38 (24.8) | 61 (25.2) | 27 (39.1) | ||
| Troponin T, median in µg/L, (IQR) | 44.8 (16.6–175.1) | 77.2 (20.6–268.5) | 38.7 (16–0–144.5) | 0.011 (− 73.8 to 8.9) | 8.0 (4.9–29.0) | < 0.001 (25.1–49.9) |
| Missing values, n (%) | 104 (26.3) | 42 (27.5) | 62 (25.6) | 30 (43.5) | ||
| D dimer, median in mg/FEU, (IQR) | 4.3 (2.4–8.5) | 4.0 (2.2–7.6) | 4.4 (2.6–8.6) | 0.079 (− 0.6 to 1.1) | 2.0 (1.3–4.2) | 0.014 (1.3–3.8) |
| Missing values, n (%) | 95 (24.1) | 34 (22.2) | 61 (25.2) | 29 (42.0) | ||
| GOT, median in U/L, (IQR) | 45.0 (30.0–77.2) | 48.0 (31.5–88.9) | 43.0 (29.0–72.0) | 0.417 (− 7.1 to 17.1) | 39.0 (25.0–79.5) | 0.388 (− 7.7 to 19.7) |
| Missing values, n (%) | 128 (32.4) | 57 (37.3) | 71 (29.3) | 11 (15.9) | ||
| GPT, median in U/L, (IQR) | 42.0 (22.0–67.0) | 48.0 (21.0–87.0) | 38.7 (23.2–59.0) | 0.264 (− 6.1 to 22.1) | 42.0 (20.5–138.2) | 1.000 (− 20.5 to 20.5) |
| Missing values, n (%) | 108 (27.3) | 46 (30.1) | 62 (25.6) | 10 (14.5) | ||
| Bilirubin, total, median in µmol/L, (IQR) | 8.6 (5.1–15.4) | 9.1 (5.3–15.4) | 8.6 (5.1–15.4) | 0.571 (− 2.6 to 4.7) | 6.8 (3.4–20.3) | 0.531 (− 3.7 to 7.1) |
| Missing values, n (%) | 221 (55.9) | 94 (61.4) | 127 (52.5) | 39 (56.5) | ||
| Albumin, median in g/dL, (IQR) | 2.7 (2.2–3.3) | 2.7 (2.2–3.2) | 2.7 (2.3–3.3) | 1.000 (− 0.2 to 0.2) | 2.9 (2.5–3.7) | 0.145 (− 0.5 to 0.1) |
| Missing values, n (%) | 138 (34.9) | 64 (41.8) | 74 (30.6) | 17 (24.6) | ||
| Creatinine, median in µmol /L, (IQR) | 46.9 (34.5–70.7) | 49.5 (33.6–79.6) | 46.0 (35.4–64.9) | 0.434 (− 5.3 to 12.3) | 26.5 (23.4–35.4) | < 0.001 (16.4–25.3) |
| Missing values, n (%) | 121 (30.6) | 53 (34.6) | 68 (28.1) | 11 (15.9) | ||
| SARS-CoV-2 PCR positive, n (%) | 54 (13.7) | 28 (18.3) | 26 (10.7) | 0.030 (− 14.5 to 0.6) | 0 | < 0.001 (5.5–21.8) |
| SARS-CoV-2 Antigen positive, n (%) | 13 (3.3) | 6 (3.9) | 7 (2.9) | 0.580 (− 4.7 to 2.6) | 0 | 0.130 (− 0.9 to 7.5) |
| SARS-CoV-2 S1 antibody positive, n (%) | 338 (85.6) | 125 (81.7) | 213 (88.0) | 0.080 (− 0.8 to 13.4) | 0 | < 0.001 (77.2–93.9) |
| SARS-CoV-2 contacts positive, n (%) | 3 (0.8) | 0 | 3 (1.2) | n.d | 0 | n.d |
PIMS, pediatric multisystem inflammatory syndrome; KD, Kawasaki disease. acomparison between PIMS-non-KD and PIMS-KD. bcomparison between PIMS-all and KD; 95% CI, 95%-confidence interval; n; number of cases; n.sh., not shown due to expected differences in case definitions; pARDS, pediatric acute respiratory distress syndrome; IQR, interquartile range; PCR, polymerase chain reaction; n.d.; not determined. P values in bold are considered statistically significant.