Giant coronary artery aneurysm as a feature of coronavirus-related inflammatory syndrome

Area of Science:

• Pediatrics
• Infectious Diseases
• Cardiology

Background:

• The coronavirus pandemic has been associated with various clinical manifestations in children.
• Kawasaki disease is an acute febrile vasculitis primarily affecting young children.
• Paediatric multisystem inflammatory syndrome (MIS-C) is a recently recognized condition linked to COVID-19.

Observation:

• A 5-month-old infant presented with fever, rash, and elevated inflammatory markers, unresponsive to antibiotics.
• The infant developed giant coronary artery aneurysms despite treatment with intravenous immunoglobulin, steroids, and immunomodulators.
• Despite an initial negative COVID-19 PCR test, the infant later showed positive COVID-19 antibodies.

Findings:

• This case demonstrates an atypical presentation resembling Kawasaki disease in an infant.
• The clinical course was complicated by the development of giant coronary artery aneurysms.
• The presence of COVID-19 antibodies suggests a link between SARS-CoV-2 infection and the observed illness.

Implications:

• This case highlights a potential association between atypical Kawasaki-like illness and MIS-C in infants.
• Early recognition and diagnosis are crucial for managing severe manifestations of MIS-C.
• Further research is needed to understand the pathophysiology and long-term outcomes of COVID-19-associated vasculitis in children.