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Kawasaki-like disease in children with COVID-19

Ummusen Kaya Akca1, Selman Kesici2, Yasemin Ozsurekci3

  • 1Division of Pediatric Rheumatology, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

Rheumatology International
|September 16, 2020
PubMed

Insights

Children with COVID-19 may develop Kawasaki-like disease, often presenting atypically. Early recognition of these hyperinflammatory conditions is crucial for timely diagnosis and treatment of Coronavirus disease 2019 in pediatric patients.

Area of Science:

  • Pediatric Infectious Diseases
  • Cardiovascular Manifestations in Children
  • Public Health & Epidemiology

Background:

  • Coronavirus disease 2019 (COVID-19) has been associated with hyperinflammatory syndromes in children.
  • Kawasaki disease (KD) and incomplete KD are recognized manifestations in pediatric COVID-19 cases.
  • Atypical presentations of KD-like illness in children warrant investigation for COVID-19.

Observation:

  • This study investigated four children with Kawasaki-like disease potentially linked to COVID-19.
  • Three patients presented with features consistent with incomplete KD.
  • Diagnostic challenges were noted, with mixed results from RT-PCR and serology for SARS-CoV-2.

Findings:

  • A literature review identified 320 children with COVID-19-associated Kawasaki-like disease.
  • SARS-CoV-2 RT-PCR was frequently negative (65.5%), while serology was often positive (83.8%).
  • Treatment strategies included intravenous immunoglobulin (IVIG), corticosteroids, and anakinra, with most patients recovering.

Implications:

  • Pediatric COVID-19 can manifest as atypical or incomplete Kawasaki-like disease.
  • Healthcare providers must maintain a high index of suspicion for KD-like symptoms in children with COVID-19.
  • Early diagnosis and appropriate management are essential to improve outcomes and prevent complications.

Keywords:
2019 novel coronavirus diseasesCOVID-19Kawasaki diseaseKawasaki-like syndromeSARS-CoV-2

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