Kawasaki-like syndrome in children from Greater Poland during the first wave of COVID-19 pandemic

Abstract

Kawasaki disease is an acute disease caused by systemic vasculitis, which predominantly affects children younger than 5 years of age. It is the leading cause of acquired coronary artery disease in childhood in developed countries. Currently, in the era of COVID-19, an increased number of cases, most likely related to SARS-CoV-2, are being observed. Our study aimed to describe the incidence and course of Kawasaki-like syndrome in patients admitted to the Polish department of infectious diseases during the first wave of COVID-19 pandemic. We identified 6 children with Kawasaki disease within almost 6 weeks of the pandemic. Medical history of 3 children showed contact with a person suspected of SARS-CoV-2 infection. One patient had confirmed SARS-CoV-2 serology (a female patient who lived in the epidemic centre). We did not confirm any bacterial or viral aetiology in 3 patients. Conclusions: Based on the conducted analysis comparing the number of cases during the “spring wave” of SARS-CoV-2 pandemic compared to previous years, an increased incidence of Kawasaki syndrome among children from the Greater Poland was found, similar to that reported by doctors from various European countries. The mean age of patients with Kawasaki disease was higher than previously reported. Analysis of clinical forms in our patients showed the entire spectrum from incomplete Kawasaki disease to full blown Kawasaki disease shock syndrome and multisystem inflammatory syndrome in children. The risk assessment of immunoglobulin resistance using the Kobayashi and Egami scores had no predictive value in patients with Kawasaki disease during the COVID-19 period.