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International Paediatric COVID experience
While the COVID-19 pandemic has resulted in an unprecedented challenge to healthcare systems and ICU resources mainly for adult patients, the ways the pandemic affected critically ill children globally have often received less attention. Contrary to previous pandemics such as the H1N1 flu, direct COVID-19-related critical illness in paediatric age groups has remained rare. Large epidemiological studies from the US and Europe indicate that the vast majority of children infected with COVID-19 remain asymptomatic. We will discuss phenotypes of COVID-19 manifestations in critically ill children and neonates, but then focus more on a unique paediatric-specific phenomenon associated with COVID-19, namely Paediatric Inflammatory Multisystem Syndrom (PIMS-TS, or MIS-C), and highlight lessons learnt from this condition. Finally, we will explore indirect impacts of the pandemic on critically ill children, including aspects such as the dilemma of restricting parental access to acutely ill children, altered non-COVID epidemiology, socioeconomic issues, and finally, how the pandemic may change the future of paediatric research.