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Effect of COVID-19 on Kawasaki Disease: Decrease Age of Onset and Increase Skin Manifestation
Hossein Esmaeilzadeh1,2,3, Negar Mortazavi4, Alireza Salehi5,6
1Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. esmailzadeh_ho@yahoo.com.
BMC Pediatrics
|December 14, 2021
Summary
Kawasaki disease (KD) admissions remained stable during the COVID-19 pandemic, with 68% of patients testing positive for the virus. Children with KD during the pandemic had an earlier age of onset and increased skin manifestations compared to previous years.
Area of Science:
- Pediatric Rheumatology
- Infectious Diseases
- Cardiology
Background:
- Kawasaki disease (KD) is a leading cause of acquired heart disease in children, with potential links to infectious triggers.
- The COVID-19 pandemic has seen vasculitis emerge as a clinical presentation in pediatric cases.
- This study investigates the association between KD and COVID-19 in hospitalized children.
Purpose of the Study:
- To assess the association between Kawasaki disease and COVID-19 in children.
- To compare demographic, clinical, laboratory, and echocardiographic findings of KD patients during the COVID-19 pandemic versus the pre-pandemic period.
- To analyze differences in KD patients based on COVID-19 status during the pandemic.
Main Methods:
- Retrospective evaluation of KD patients hospitalized between February and September 2020 (Group 1) and compared with the same period in 2019 (Group 2).
- COVID-19 testing was performed on Group 1 patients.
- Comparison of clinical, laboratory, and echocardiographic data between the two groups and between COVID-19 positive and negative patients in Group 1.
Main Results:
- 68% of KD patients hospitalized in 2020 tested positive for COVID-19.
- KD patients during the pandemic (Group 1) had a significantly lower age of onset (4.38 years) compared to the pre-pandemic group (Group 2, 5.5 years).
- While most features were similar, COVID-19 positive patients showed a higher incidence of rash, whereas COVID-19 negative patients had more coronary artery abnormalities.
Conclusions:
- Kawasaki disease admission rates were similar during the COVID-19 pandemic, but a significant proportion of admitted patients were co-infected with COVID-19.
- The pandemic period was associated with an earlier age of onset and increased skin manifestations in pediatric patients with Kawasaki disease.
- COVID-19 co-infection in KD patients presented with distinct clinical features, including a higher prevalence of rash.
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