Pre-COVID-19 Kawasaki disease and COVID-19 era multisystem inflammatory syndrome in children

Abstract

Context: Multisystem inflammatory syndrome in children (MIS-C) seen during the COVID-19 pandemic time most likely represents a severe variant of Kawasaki disease (KD). Aim: The aim of this study was to study the clinical difference between KD and MIS-C. Study Design: A prospective observational study of MIS-C patients was done during the COVID-19 pandemic period and a descriptive comparative study was done with available institutional data on KD. Materials and Methods: Consecutive patients admitted with clinical features of MIS-C were enrolled and compared with the available records on KD patients. Statistical Analysis Used: Qualitative data were analyzed using percentages and proportions. Quantitative data were analyzed using mean, standard deviation, and median. Differences between groups were compared with Student's t-test for parametric continuous variables. Results: Thirty-three pre-COVID-19 KD patients and 28 MIS-C patients were compared. Median age in KD and MIS-C was 2.4 and 7.7 years, respectively (P < 0.001). More gastrointestinal and neurological symptoms were seen in MIS-C (P < 0.001). KD patients had more leukocytosis, raised erythrocyte sedimentation rate, and thrombocytosis. MIS-C patients had higher mean levels of procalcitonin, ferritin, troponin, and brain natriuretic peptide. Coronary artery aneurysms and mitral regurgitation occurrence were similar in both, with a higher incidence of left ventricular dysfunction in MIS-C.