The worldwide outbreak of the novel 2019 coronavirus disease (COVID-19) has led to recognition of a new immunopathological condition: paediatric inflammatory multisystem syndrome (PIMS-TS). The Czech Republic (CZ) suffered from one of the highest incidences of individuals who tested positive during pandemic waves. The aim of this study was to analyse epidemiological, clinical, and laboratory characteristics of all cases of paediatric inflammatory multisystem syndrome (PIMS-TS) in the Czech Republic (CZ) and their predictors of severe course. We performed a retrospective-prospective nationwide observational study based on patients hospitalised with PIMS-TS in CZ between 1 November 2020 and 31 May 2021. The anonymised data of patients were abstracted from medical record review. Using the inclusion criteria according to World Health Organization definition, 207 patients with PIMS-TS were enrolled in this study. The incidence of PIMS-TS out of all SARS-CoV-2-positive children was 0.9:1,000. The estimated delay between the occurrence of PIMS-TS and the COVID-19 pandemic wave was 3 weeks. The significant initial predictors of myocardial dysfunction included mainly cardiovascular signs (hypotension, oedema, oliguria/anuria, and prolonged capillary refill). During follow-up, most patients (98.8%) had normal cardiac function, with no residual findings. No fatal cases were reported.Conclusions: A 3-week interval in combination with incidence of COVID-19 could help increase pre-test probability of PIMS-TS during pandemic waves in the suspected cases. Although the parameters of the models do not allow one to completely divide patients into high and low risk groups, knowing the most important predictors surely could help clinical management.

Central European Institute of Technology Masaryk University Brno Czech Republic

Department of Immunology 2nd Faculty of Medicine Charles University and University Hospital Motol Prague Czech Republic

Department of Paediatrics 1st Faculty of Medicine Charles University and University Thomayer Hospital Prague Czech Republic

Department of Paediatrics 2nd Faculty of Medicine Charles University and University Hospital Motol 5 Úvalu 84 150 06 Prague Czech Republic

Department of Paediatrics and Inherited Metabolic Disorders 1st Faculty of Medicine Charles University and General University Hospital Prague Czech Republic

Department of Paediatrics Faculty of Medicine Charles University and University Hospital Hradec Králové Hradec Králové Czech Republic

Department of Paediatrics Faculty of Medicine Charles University and University Hospital Plzeň Plzeň Czech Republic

Department of Paediatrics Faculty of Medicine Masaryk University and University Hospital Brno Brno Czech Republic

Department of Paediatrics Faculty of Medicine Palacky University and University Hospital Olomouc Olomouc Czech Republic

Department of Paediatrics Faculty of Medicine University of Ostrava and University Hospital Ostrava Ostrava Czech Republic

Department of Paediatrics Regional Bata Hospital Zlín Czech Republic

Department of Paediatrics Regional Hospital Kolín Czech Republic

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