Prevalence and Clinical Characteristics of SARS-CoV-2 Confirmed and Negative Kawasaki Disease Patients During the Pandemic in Spain

Published on Jan 18, 2021in Frontiers in Pediatrics3.418
· DOI :10.3389/FPED.2020.617039
Elisa Fernández-Cooke6
Estimated H-index: 6
,
Carlos Grasa4
Estimated H-index: 4
(Hospital Universitario La Paz)
+ 17 AuthorsCristina Calvo25
Estimated H-index: 25
(Hospital Universitario La Paz)
Sources
Abstract
Introduction: COVID-19 has a less severe course in children. In April 2020 some children presented with signs of multisystem inflammation with clinical signs overlapping with Kawasaki disease (KD), most of them requiring admission to the pediatric intensive care unit (PICU). This study aimed to describe the prevalence and clinical characteristics of KD SARS-CoV-2 confirmed and negative patients during the pandemic in Spain. Material and methods: Medical data of KD patients from 1st January 2018 until 30th May 2020 was collected from the KAWA-RACE study group. We compared the KD cases diagnosed during the COVID-19 period (1st March-30th May 2020) that were either SARS-CoV-2 confirmed (CoV+) or negative (CoV-) to those from the same period during 2018 and 2019 (PreCoV). Results: one hundred and twenty-four cases were collected. There was a significant increase in cases and PICU admissions in 2020 (P-trend = 0.001 and 0.0004 respectively). CoV+ patients were significantly older (7.5 vs 2.5yr) and mainly non-Caucasian (64 vs 29%), had incomplete KD presentation (73 vs 32%), lower leucocyte (9.5 vs 15.5x109) and platelet count (174 vs 423x109/L), higher inflammatory markers (C-Reactive Protein 18.5 vs 10.9 mg/dl) and terminal segment of the natriuretic atrial peptide (4766 vs 505 pg/ml), less aneurysm development (3.8 vs 11.1%) and more myocardial dysfunction (30.8 vs 1.6%) than PreCoV patients. Respiratory symptoms were not increased during the COVID-19 period. Conclusion: The KD CoV+ patients mostly meet pediatric inflammatory multisystem syndrome temporally associated with COVID-19/multisystem inflammatory syndrome in children criteria. Whether this is a novel entity or the same disease on different ends of the spectrum is yet to be clarified.
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Several studies demonstrated that COVID-19 in children is a relatively mild disease. However, recently a more serious condition characterized by systemic inflammation with clinical or microbiological evidence of exposure to SARS-CoV-2 has been described. This syndrome is now known as either "Pediatric Inflammatory Multisystem Syndrome temporally related with COVID-19" (PIMS-TS) (1), or Multisystem Inflammatory Syndrome in Children (MIS-C) (2) and is currently considered a rare post-COVID-19 comp...
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#1Zahra Belhadjer (University of Paris)H-Index: 4
#2Mathilde MeotH-Index: 4
Last. Damien Bonnet (University of Paris)H-Index: 90
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Background: Cardiac injury and myocarditis have been described in adults with COVID-19. SARS-CoV-2 infection in children is typically minimally symptomatic. We report a series of febrile pediatric ...
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#1Elizabeth Whittaker (Imperial College London)H-Index: 23
#2Alasdair Bamford (GOSH: Great Ormond Street Hospital)H-Index: 10
Last. Perform ConsortiaH-Index: 1
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Importance In communities with high rates of coronavirus disease 2019, reports have emerged of children with an unusual syndrome of fever and inflammation. Objectives To describe the clinical and laboratory characteristics of hospitalized children who met criteria for the pediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (PIMS-TS) and compare these characteristics with other pediatric inflammatory disorders. Design...
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#1Elizabeth A. Williamson (Lond: University of London)H-Index: 72
#2Alex J Walker (University of Oxford)H-Index: 23
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Coronavirus disease 2019 (COVID-19) has rapidly affected mortality worldwide1. There is unprecedented urgency to understand who is most at risk of severe outcomes, and this requires new approaches for the timely analysis of large datasets. Working on behalf of NHS England, we created OpenSAFELY—a secure health analytics platform that covers 40% of all patients in England and holds patient data within the existing data centre of a major vendor of primary care electronic health records. Here we us...
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Abstract Background Studies summarizing the clinical picture of COVID-19 in children are lacking. This review characterizes clinical symptoms, laboratory, and imaging findings, as well as therapies provided to confirmed pediatric cases of COVID-19. Methods Adhering to PRISMA guidelines, we searched four medical databases (PubMed, LitCovid, Scopus, WHO COVID-19 database) between December 1, 2019 to May 14, 2020 using the keywords “novel coronavirus”, “COVID-19” or “SARS-CoV-2”. We included publis...
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#1Leora R Feldstein (Emory University)H-Index: 15
#2Erica B. Rose (Emory University)H-Index: 1
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Abstract Background Understanding the epidemiology and clinical course of multisystem inflammatory syndrome in children (MIS-C) and its temporal association with coronavirus disease 2019 (Covid-19)...
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Children were relatively spared during COVID-19 pandemic. However, the recently reported hyperinflammatory syndrome with overlapping features of Kawasaki disease and toxic shock syndrome-"Paediatric Inflammatory Multisystem Syndrome-temporally associated with SARS-CoV-2" (PIMS-TS) has caused concern. We describe cardiac findings and short-term outcomes in children with PIMS-TS at a tertiary children's hospital. Single-center observational study of children with PIMS-TS from 10th April to 9th May...
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#1Lucio VerdoniH-Index: 3
#2Angelo MazzaH-Index: 10
Last. Lorenzo D'AntigaH-Index: 27
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Summary Background The Bergamo province, which is extensively affected by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic, is a natural observatory of virus manifestations in the general population. In the past month we recorded an outbreak of Kawasaki disease; we aimed to evaluate incidence and features of patients with Kawasaki-like disease diagnosed during the SARS-CoV-2 epidemic. Methods All patients diagnosed with a Kawasaki-like disease at our centre in the past 5...
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#2Clément Poirault (University of Paris)H-Index: 3
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Abstract Objectives To describe the characteristics of children and adolescents affected by an outbreak of Kawasaki-like multisystem inflammatory syndrome and to evaluate a potential temporal association with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Design Prospective observational study. Setting General paediatric department of a university hospital in Paris, France. Participants 21 children and adolescents (aged ≤18 years) with features of Kawasaki disease who we...
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#1Andrea Wolfler (Boston Children's Hospital)H-Index: 16
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Cited By1
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#2Ayşenur Paç Kısaarslan (Erciyes University)H-Index: 3
Last. Kubra Ozturk (Istanbul Medeniyet University)H-Index: 4
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To compare the clinical and laboratory findings of multisystem inflammatory syndrome in children (MIS-C), patients with Kawasaki disease (KD) and with macrophage activating syndrome due to systemic juvenile idiopathic arthritis (sJIA-MAS) on real-life data. Patients diagnosed with MIS-C, KD, and sJIA-MAS from 12 different centers in Turkey who were followed for at least 6 months were included in the study. Demographic, clinical, and laboratory findings of all patients were analyzed. A total of 1...
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