Abstract: Serious illness requiring intensive care is relatively rare in childhood. Across the four nations of the UK, 26 PICUs are commissioned, but in 2020 a single PICU was unlikely to admit more than a few children with severe COVID-19. However, among them there were some with a pandemic-related paediatric phenotype, the paediatric multisystem inflammatory syndrome temporally associated with SARS-CoV-2 (PIMS-TS; affecting the kidneys, heart, lungs and brain).3 The existence of an excellent national audit, collecting data from PICUs, allowed it to be characterised, while further insights came from enrolment of children in large national studies, such as the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) study and Randomised Evaluation of COVID-19 Therapy (RECOVERY) trials.