Kawasaki-like disease in children with COVID-19

Akca U. K., Kesici S., Özsürekci Y., Aykan H. H., Batu Akal E. D., Atalay E., ...More

RHEUMATOLOGY INTERNATIONAL, vol.40, no.12, pp.2105-2115, 2020 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Review
  • Volume: 40 Issue: 12
  • Publication Date: 2020
  • Doi Number: 10.1007/s00296-020-04701-6
  • Journal Name: RHEUMATOLOGY INTERNATIONAL
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database
  • Page Numbers: pp.2105-2115
  • Keywords: COVID-19, Kawasaki-like syndrome, 2019 novel coronavirus diseases, SARS-CoV-2, Kawasaki disease, MULTISYSTEM INFLAMMATORY SYNDROME, FAMILIAL MEDITERRANEAN FEVER, BCG VACCINATION, INFECTION, CORONAVIRUS, INVOLVEMENT, EPICENTER, EPIDEMIC, CARRIERS
  • Eskisehir Osmangazi University Affiliated: No

Abstract

Children with Coronavirus disease 2019 (COVID-19) are being reported to have manifestations of hyperinflammatory states and/or Kawasaki-like disease. In this study, we investigated children with typical and atypical Kawasaki disease (KD) likely to be associated with COVID-19. We have reported four children with Kawasaki-like disease probably associated with COVID-19. The clinical features were consistent with incomplete KD in three patients. SARS-CoV-2 RT-PCR was positive in one and the serology was positive in one patient with negative RT-PCR. Corticosteroids, anakinra, intravenous immunoglobulin (IVIG), and acetylsalicylic acid were used in the treatment. Three patients recovered after the treatment while one patient died. The literature review revealed 36 articles describing 320 children with Kawasaki-like disease associated with COVID-19. SARS-CoV-2 RT-PCR was negative in 120 (65.5%) of 183 patients while the serology was positive in 130 (83.8%) of 155 patients. The therapeutic options have included IVIG, acetylsalicylic acid, tocilizumab, anakinra, enoxaparin, and methylprednisolone. Pediatric COVID-19 cases may present with atypical/incomplete Kawasaki-like disease. Thus, pediatricians need to be aware of such atypical presentations resembling KD for early diagnosis of COVID-19.