Possible involvement of infection with human coronavirus 229E, but not NL63, in Kawasaki disease

Shirato, Kunio; Imada, Yoshio; Kawase, Miyuki; Nakagaki, Keiko; Matsuyama, Shutoku; Taguchi, Fumihiro

doi:10.1002/jmv.23950

Cited by 90 publications

(91 citation statements)

References 47 publications

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“…Interestingly, both presentations were quite similar, with acute abdominal pain and fever that led to a false diagnosis of appendicitis (and appendectomy) before the diagnosis of PIMS-TS was confirmed. Several studies have described this aberrant immune reaction to SARS-CoV-2 infection, with excessive inflammation leading to acute heart failure [ 27 , 28 , 29 , 30 , 31 , 32 ], which had previously been reported for other viruses, such as Coronavirus 229E [ 33 ].…”

Section: Discussionmentioning

confidence: 92%

The Wide Spectrum of COVID-19 Clinical Presentation in Children

Nathan

Prévost

Sileo

et al. 2020

JCM

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Background: Ten months after its appearance in December 2019, SARS-CoV-2 has infected more than 25 million patients worldwide. Because children were first identified as potential spreaders of the virus, schools were closed in several countries. However, it rapidly became evident that the number of hospitalized children infected by SARS-CoV-2 was dramatically lower than that of adults. To date, only hypotheses have been raised to explain this difference, so it is of great importance to describe the presentation of this disease among children. Here, we describe a wide spectrum of COVID-19 manifestation in children in a dedicated pediatric unit in France. Methods: Patients hospitalized with COVID-19 who were diagnosed on the basis of either positive SARS-CoV-2 RT-PCR in nasopharyngeal swabs and/or typical aspects in chest-computed tomography (CT) were included between March and May 2020 in Paris. Results: Twenty-three patients were included on the basis of positive RT-PCR (n = 20) and/or typical aspects in CT (n = 4). The median age was 4.9 years [0.1–17.6]. Patients were grouped by age (<2 years old: n = 14, 61%; 2–10 years old: n = 2, 9%; >10 years old: n = 7, 30%). Overweight or obesity was reported in only three patients. At presentation, the most frequent symptom in the overall cohort was fever (n = 18, 78%), followed by acute rhinitis (n = 9, 64%) and cough (n = 7, 50%) in the under 2-year-old group and cough (n = 4, 57%), fatigue, dyspnea and abdominal pain (n = 3, 43% each) in the over 10-year-old group. Five patients required ICU treatment, four of whom were aged >10 years, two presented with acute myocarditis, and two were sickle cell disease patients who presented with acute chest syndrome. Discussion and conclusion: The youngest patients seem to present milder forms of COVID-19 without the need for ICU treatment and with a shorter length of hospitalization. More severe evolutions were observed in teenagers, with, however, favorable outcomes. Given the context of closed schools and confinement, the infection of these children suggests intra-familial transmission that needs to be further assessed. This description might help to understand the intriguing differences in COVID-19 severity across age-classes.

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Section: Discussionmentioning

confidence: 92%

The Wide Spectrum of COVID-19 Clinical Presentation in Children

Nathan

Prévost

Sileo

et al. 2020

JCM

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“…As in the adult, it can be hypothesized that SARS-CoV-2 infection could induce an inappropriate immune response, causing an inflammatory reaction leading to vasculitis [ 11 , 23 , 24 ]. Another possibility is that inflammatory diseases like Kawasaki and myocarditis could directly result in an endothelial lesion provoked by a specific virus [ 1 , 25 , 26 ]. Finally, these types of inflammatory diseases could depend on the external viral pressure.…”

Section: Discussionmentioning

confidence: 99%

Paediatric multisystem inflammatory syndrome associated with COVID-19: filling the gap between myocarditis and Kawasaki?

et al. 2020

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Myocarditis and Kawasaki disease are common but usually distinct diseases in children. During the coronavirus pandemic (COVID-19), reports of a new form of myocarditis with clinical features of Kawasaki appeared. We investigated the place of this new disease in the spectrum encompassing Kawasaki disease and myocarditis. Thirty two consecutive children referred to our centre for a suspicion of Kawasaki or a diagnosis of myocarditis were included and eventually divided into four groups: 11 Kawasaki diseases, 6 Kawasaki syndromes (children with another diagnosis), 7 myocarditis without Kawasaki clinical feature and 7 myocarditis with incomplete Kawasaki clinical features. All were treated with immunoglobulins except those of the myocarditis group. The survival rate was 91%. The 7 children with myocarditis and clinical features of incomplete Kawasaki were all positive for SARS-CoV-2. They had a transient myocardial failure with a favourable course and none had coronary artery disease. Conclusion : Every COVID-19 child within our population had a mild to severe myocarditis and presented with fever plus two or three Kawasaki clinical features. Short-term evolution was good for these children. This new disease seems to fill the gap between isolated myocarditis and Kawasaki disease. What is Known: • A new paediatric disease close to Kawasaki disease appeared during the COVID-19 pandemic What is New: • In our population , children presented with fever , vivid Kawasaki clinical features ( although the Kawasaki syndrome was always incomplete ) and a myocarditis without coronary abnormalities. • The new disease fills the gap between paediatric myocarditis and Kawasaki disease but its prognosis is much better.

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“…The exact pathogenesis of KD is still unknown. There are reports that viruses from coronavirus family might be associated with the development of KD, however these results need further verification ( Shirato et al, 2014 ; Verdoni et al, 2020 ). The studies report that the majority of children affected with PIMS were not having active COVID-19 infection, but IgG and IgM antibodies against SARS-CoV-2 were elevated in laboratory findings ( Whittaker et al, 2020 ).…”

Section: Pediatric Inflammatory Multisystem Syndrome In Childrenmentioning

confidence: 96%

Pathophysiology of Cardiovascular Complications in COVID-19

Petrović

Radenković

et al. 2020

Front. Physiol.

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Numerous recent studies have shown that patients with underlying cardiovascular disease (CVD) are at increased risk of more severe clinical course as well as mortality of COVID-19. Also, the available data suggests that COVID-19 is related to numerous de novo cardiovascular complications especially in the older population and those with pre-existing chronic cardiometabolic conditions. SARS-CoV-2 virus can cause acute cardiovascular injury, as well as increase the risk of chronic cardiovascular damage. As CVD seem to be the major comorbidity in critically unwell patients with COVID-19 and patients often die of cardiovascular complications, we review the literature and discuss the possible pathophysiology and molecular pathways driving these disease processes: cytokine release syndrome, RAAS system dysregulation, plaque destabilization and coagulation disorders with the aim to identify novel treatment targets. In addition, we review the pediatric population, the major cause of the cardiovascular complications is pediatric inflammatory multisystem syndrome that is believed to be associated with COVID-19 infection. Due to the increasingly recognized CVD damage in COVID-19, there is a need to establish clear clinical and follow-up protocols and to identify and treat possible comorbidities that may be risk factors for the development of cardiovascular complications.

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Possible involvement of infection with human coronavirus 229E, but not NL63, in Kawasaki disease

Cited by 90 publications

References 47 publications

The Wide Spectrum of COVID-19 Clinical Presentation in Children

The Wide Spectrum of COVID-19 Clinical Presentation in Children

Paediatric multisystem inflammatory syndrome associated with COVID-19: filling the gap between myocarditis and Kawasaki?

Pathophysiology of Cardiovascular Complications in COVID-19

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