BackgroundCurrent data suggest that COVID-19 is less frequent in children, with a milder course. However, over the past weeks, an increase in the number of children presenting to hospitals in the greater Paris region with a phenotype resembling Kawasaki disease (KD) has led to an alert by the French national health authorities.MethodsMulticentre compilation of patients with KD in Paris region since April 2020, associated with the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (‘Kawa-COVID-19’). A historical cohort of ‘classical’ KD served as a comparator.ResultsSixteen patients were included (sex ratio=1, median age 10 years IQR (4·7 to 12.5)). SARS-CoV-2 was detected in 12 cases (69%), while a further three cases had documented recent contact with a quantitative PCR-positive individual (19%). Cardiac involvement included myocarditis in 44% (n=7). Factors prognostic for the development of severe disease (ie, requiring intensive care, n=7) were age over 5 years and ferritinaemia >1400 µg/L. Only five patients (31%) were successfully treated with a single intravenous immunoglobulin (IVIg) infusion, while 10 patients (62%) required a second line of treatment. The Kawa-COVID-19 cohort differed from a comparator group of ‘classical’ KD by older age at onset 10 vs 2 years (p<0.0001), lower platelet count (188 vs 383 G/L (p<0.0001)), a higher rate of myocarditis 7/16 vs 3/220 (p=0.0001) and resistance to first IVIg treatment 10/16 vs 45/220 (p=0.004).ConclusionKawa-COVID-19 likely represents a new systemic inflammatory syndrome temporally associated with SARS-CoV-2 infection in children. Further prospective international studies are necessary to confirm these findings and better understand the pathophysiology of Kawa-COVID-19.Trial registration numberNCT02377245
International audienceAvalanche fluctuations set a limit to the energy and position resolutions that can be reached by gaseous detectors. This paper presents a method based on a laser test-bench to measure the absolute gain and the relative gain variance of a Micro-Pattern Gaseous Detector from its single-electron response. A Micromegas detector was operated with three binary gas mixtures, composed of 5% isobutane as a quencher, with argon, neon or helium, at atmospheric pressure. The anode signals were read out by low-noise, high-gain Cremat CR-110 charge preamplifiers to enable single-electron detection down to gain of 5× 103 for the first time. The argon mixture shows the lowest gain at a given amplification field together with the lowest breakdown limit, which is at a gain of 2×104 an order of magnitude lower than that of neon or helium. For each gas, the relative gain variance f is almost unchanged in the range of amplification field studied. It was found that f is twice higher (f~0.6) in argon than in the two other mixtures. This hierarchy of gain and relative gain variance agrees with predictions of analytic models, based on gas ionisation yields, and a Monte-Carlo model included in the simulation software Magboltz version 10.1
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