Abstract
Viral infections have been described as triggers for Kawasaki Disease (KD), a medium vessel vasculitis that affects young children. Akin to the H1N1 pandemic in 2009, there is a similar rise in the incidence of KD in children affected with Coronavirus disease 2019 (COVID-19). Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2) has been reported to induce an exaggerated systemic inflammatory response resulting in multi-organ involvement, particularly initiated with pulmonary parenchymal damage. This review article will discuss KD-like manifestations in COVID-19 patients in the pediatric cohort. Search terms "Kawasaki" "COVID-19" "SARS-COV-2" "PIM-TS" and "MIS-C" were used to look for relevant articles in PubMed and Google Scholar published in the last 5 years. There is some evidence to suggest that SARS-CoV-2 stimulates dysfunctional and hyperactive immune reactions mimicking KD in young patients. Therapeutic options, both investigational and repurposed, include intravenous immunoglobulins, steroids and anticoagulation. More studies are required to evaluate the effectiveness of these treatment options.
Highlights
Viral infections have been described as triggers for Kawasaki Disease (KD), a medium vessel vasculitis that affects young children
An exorbitant immune system activation may occur in Kawasaki disease (KD) causing macrophage activation syndrome (MAS), a rare complication that can occur at any stage of KD and lead to increased cardiac complications and high mortality, highlighting the importance of timely diagnosis and management [14]
This study suggests Kawasaki-like symptoms tend to occur several weeks after Severe Acute Respiratory Syndrome (SARS)-COV-2 infection, causing severe illness requiring intensive care intervention due to inflammation of the myocardium in almost half of the patients studied
Summary
The Coronavirus 2019 (COVID-19) pandemic has stressed healthcare systems globally. The heterogeneity in presentations of COVID-19, coupled with varying severity and outcomes across different age groups, are constant challenges both for clinicians and researchers. This review article will discuss KD-like manifestations in COVID-19 patients in the pediatric cohort
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