COVID-19 and Kawasaki Disease: An Etiology or Coincidental Infection?

Raba, Ali Ahmed; Abobaker, Anis

doi:10.1097/inf.0000000000002779

Cited by 9 publications

(11 citation statements)

References 5 publications

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“…Most MIS-C patients show clinical manifestations and laboratory findings similar to KD, so the pathogenesis of MIS-C and KD might be the same. 22,23) The pathogenesis of KD is explained by the theory of abnormal or dysregulated immune reactions.…”

Section: Pathogenesis Of Mis-cmentioning

confidence: 99%

Clinical features, diagnosis, and outcomes of multisystem inflammatory syndrome in children associated with coronavirus disease 2019

2021

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The novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been spreading worldwide since December 2019. Hundreds of cases of children and adolescents with Kawasaki disease (KD)–like hyperinflammatory illness have been reported in Europe and the United States during the peak of the COVID-19 pandemic with or without shock and cardiac dysfunction. These patients tested positive for the polymerase chain reaction or antibody test for SARS-CoV-2 or had a history of recent exposure to COVID-19. Clinicians managing such patients coined new terms for this new illness, such as COVID-19–associated hyperinflammatory response syndrome, pediatric inflammatory multisystem syndrome temporally associated with COVID-19, or COVID-19–associated multisystem inflammatory syndrome in children (MIS-C). The pathogenesis of MIS-C is unclear; however, it appears similar to that of cytokine storm syndrome. MIS-C shows clinical features similar to KD, but differences between them exist with respect to age, sex, and racial distributions and proportions of patients with shock or cardiac dysfunction. Recommended treatments for MIS-C include intravenous immunoglobulin, corticosteroids, and inotropic or vasopressor support. For refractory patients, monoclonal antibody to interleukin-6 receptor (tocilizumab), interleukin-1 receptor antagonist (anakinra), or monoclonal antibody to tumor necrosis factor (infliximab) may be recommended. Patients with coronary aneurysms require aspirin or anticoagulant therapy. The prognosis of MIS-C seemed favorable without sequelae in most patients despite a reported mortality rate of approximately 1.5%.

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Section: Pathogenesis Of Mis-cmentioning

confidence: 99%

Clinical features, diagnosis, and outcomes of multisystem inflammatory syndrome in children associated with coronavirus disease 2019

2021

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“…53 However, concerns have been raised regarding that a multisystem inflammatory syndrome similar to Kawasaki disease could be related to COVID-19 in children. 54 Reports have described children diagnosed with Kawasaki-like illness in the setting of confirmed COVID-19 infection. 55,56 A retrospective study from Italy showed a 30-fold increased incidence of Kawasaki-like disease cases in the Bergamo province following the COVID-19 epidemic, compared to the monthly incidence of the previous 5 years.…”

Section: Atypical Presentations In Childrenmentioning

confidence: 99%

“…57 Although the etiology of Kawasaki disease remains unknown, the possible association between Covid-19 and Kawasaki disease cannot be excluded. 54 Recent studies have also shown that infants are more likely to present with atypical clinical symptoms, compared to older children. 58 A study reported five infants diagnosed with COVID-19, who presented with isolated fever and reduced oral intake, without associated respiratory symptoms.…”

Section: Atypical Presentations In Childrenmentioning

confidence: 99%

“…Children with COVID‐19 have been reported to present as asymptomatic or only with mild symptoms of the respiratory or gastrointestinal system 53 . However, concerns have been raised regarding that a multisystem inflammatory syndrome similar to Kawasaki disease could be related to COVID‐19 in children 54 . Reports have described children diagnosed with Kawasaki‐ like illness in the setting of confirmed COVID‐19 infection 55,56 .…”

Section: Extrapulmonary and Atypical Clinical Features Of Covid‐19mentioning

confidence: 99%

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Extrapulmonary and atypical clinical presentations of COVID‐19

Abobaker

Raba

Alzwi³

2020

Journal of Medical Virology

Self Cite

102

100

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The novel coronavirus (SARS-CoV2) has led to an outbreak of multiple cases of pneumonia in Wuhan city in December 2019. The disease caused by this virus was named coronavirus disease 2019 or "COVID-19", which was declared by the World Health Organization as a global pandemic in March 2020. It typically presents with respiratory symptoms and febrile illness. However, there are few reported extrapulmonary and atypical presentations, such as hemoptysis, cardiac, neurological, gastrointestinal, ocular, and cutaneous manifestations, as well as venous and arterial thrombosis. Lack of awareness of these presentations might lead to misdiagnosis, delayed diagnosis, and isolation of suspected patients which increases the risk of transmission of infection between patients and doctors. All these issues will be discussed in this review.

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“…[51] Cross-reactivity between a microbial antigen and host tissues, where epitopes are shared (molecular mimicry), is also a possibility. [52] Lastly, it is possible that SARS-CoV-2 may act as an adjuvant factor for the, as yet, unknown trigger in MIS-C. [50] Implications for therapy Multiple therapeutic strategies are being considered for patients with more severe COVID-19 and these are summarised in Table 1. [4,48, Some (in bold in the table) are effective and widely used therapies for severe COVID-19.…”

Section: Other Contributors To Disease Severity and Complications Of mentioning

confidence: 99%

Rapid evolution of our understanding of the pathogenesis of COVID-19: Implications for therapy

2020

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COVID-19 and Kawasaki Disease: An Etiology or Coincidental Infection?

Cited by 9 publications

References 5 publications

Clinical features, diagnosis, and outcomes of multisystem inflammatory syndrome in children associated with coronavirus disease 2019

Clinical features, diagnosis, and outcomes of multisystem inflammatory syndrome in children associated with coronavirus disease 2019

Extrapulmonary and atypical clinical presentations of COVID‐19

Rapid evolution of our understanding of the pathogenesis of COVID-19: Implications for therapy

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