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01-12-2020 | Coronavirus | Case Based Review

Kawasaki-like disease in children with COVID-19

Authors: Ummusen Kaya Akca, Selman Kesici, Yasemin Ozsurekci, Hayrettin Hakan Aykan, Ezgi Deniz Batu, Erdal Atalay, Selcan Demir, Erdal Sag, Dogus Vuralli, Benan Bayrakci, Yelda Bilginer, Seza Ozen

Published in: Rheumatology International | Issue 12/2020

Abstract

Children with Coronavirus disease 2019 (COVID-19) are being reported to have manifestations of hyperinflammatory states and/or Kawasaki-like disease. In this study, we investigated children with typical and atypical Kawasaki disease (KD) likely to be associated with COVID-19. We have reported four children with Kawasaki-like disease probably associated with COVID-19. The clinical features were consistent with incomplete KD in three patients. SARS-CoV-2 RT-PCR was positive in one and the serology was positive in one patient with negative RT-PCR. Corticosteroids, anakinra, intravenous immunoglobulin (IVIG), and acetylsalicylic acid were used in the treatment. Three patients recovered after the treatment while one patient died. The literature review revealed 36 articles describing 320 children with Kawasaki-like disease associated with COVID-19. SARS-CoV-2 RT-PCR was negative in 120 (65.5%) of 183 patients while the serology was positive in 130 (83.8%) of 155 patients. The therapeutic options have included IVIG, acetylsalicylic acid, tocilizumab, anakinra, enoxaparin, and methylprednisolone. Pediatric COVID-19 cases may present with atypical/incomplete Kawasaki-like disease. Thus, pediatricians need to be aware of such atypical presentations resembling KD for early diagnosis of COVID-19.

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Title: Kawasaki-like disease in children with COVID-19
Authors: Ummusen Kaya Akca
Selman Kesici
Yasemin Ozsurekci
Hayrettin Hakan Aykan
Ezgi Deniz Batu
Erdal Atalay
Selcan Demir
Erdal Sag
Dogus Vuralli
Benan Bayrakci
Yelda Bilginer
Seza Ozen
Publication date: 01-12-2020
Publisher: Springer Berlin Heidelberg
Keywords: Coronavirus
SARS-CoV-2
Acetylsalicylic Acid
COVID-19
Acetylsalicylic Acid
Kawasaki Disease
Kawasaki Disease
Kawasaki Disease
Published in: Rheumatology International / Issue 12/2020
Print ISSN: 0172-8172
Electronic ISSN: 1437-160X
DOI: https://doi.org/10.1007/s00296-020-04701-6

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