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

Frontiers in Pediatrics

article

Elisa Fernández-Cooke¹  María Luisa Navarro Gómez³  Manuel Oltra Benavent⁴  Gemma Giralt⁵  Matilde Bustillo⁶  Ana María Bello Naranjo⁷  Beatriz Rocandio⁸  Moisés Rodríguez-González⁹  Esmeralda Núñez Cuadros^1,10  Javier Aracil Santos^1,11  David Moreno^1,10  Carlos D. Grasa^1,11  Cristina Calvo^1,11  Sara Domínguez-Rodríguez²  Ana Barrios Tascón^1,12  Judith Sánchez-Manubens^1,13  Jordi Anton^1,13  Beatriz Mercader^1,14  Enrique Villalobos^1,15  Marisol Camacho^1,16 

[1] Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital Universitario 12 de Octubre;Pediatric Research and Clinical Trials Unit (UPIC), Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12);Department of Pediatrics, Hospital Universitario Gregorio Marañón;Department of Pediatrics, Hospital Universitario y Politécnico La Fe;Pediatric Cardiology Unit, Department of Pediatrics, Hospital Universitario Vall d'Hebron Barcelona;Pediatric Infectious Disease Unit, Department of Pediatrics, Hospital Universitario Miguel Servet;Department of Pediatrics, Hospital Universitario Materno-Infantil de Las Palmas de Gran Canaria;Department of Pediatrics, Hospital Universitario de Donostia;Department of Pediatrics, Hospital Universitario Puerta Del Mar de Cádiz;Department of Pediatrics, Hospital Regional Universitario de Málaga;Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital Universitario La Paz;Department of Pediatrics, Hospital Universitario Infanta Sofia;Pediatric Rheumatology Department, Hospital Sant Joan de Déu, Universitat Autònoma de Barcelona;Department of Pediatrics, Hospital Clínico Universitario Virgen de la Arrixaca;Department of Pediatrics, Hospital Infantil Universitario Niño Jesús;Rheumatology and Immunology Unit, Department of Pediatrics, Hospital Virgen del Rocío

关键词: Kawasaki disease (KD);    children;    SARS-CoV-2;    COVID-19;    shock;    multisystem inflammatory syndrome in children (MIS-C);    pediatric inflammatory multisystem syndrome (PIMS-TS);   

DOI  :  10.3389/fped.2020.617039

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

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 January 1, 2018 until May 30, 2020 was collected from the KAWA-RACE study group. We compared the KD cases diagnosed during the COVID-19 period (March 1–May 30, 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. 2.5 yr) and mainly non-Caucasian (64 vs. 29%), had incomplete KD presentation (73 vs. 32%), lower leucocyte (9.5 vs. 15.5 × 10 9 ) and platelet count (174 vs. 423 × 10 9 /L), higher inflammatory markers (C-Reactive Protein 18.5vs. 10.9 mg/dl) and terminal segment of the natriuretic atrial peptide (4,766 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.

【 授权许可】

CC BY