Prevalence and Clinical Characteristics of SARS-CoV-2 Confirmed and Negative Kawasaki Disease Patients During the Pandemic in Spain
Fernández-Cooke, Elisa (Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12))
Grasa, Carlos D. (Hospital Universitario La Paz (Madrid))
Domínguez-Rodríguez, Sara (Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12))
Barrios Tascón, Ana (Hospital Universitario Infanta Sofía (San Sebastián de los Reyes))
SánchezManubens, Judith (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i Medicina Preventiva i Salut Pública)
Antón, Jordi (Hospital Sant Joan de Déu (Manresa))
Mercader, Beatriz (Hospital Clínico Universitario Virgen de la Arrixaca (El Palmar, Múrcia))
Villalobos, Enrique (Hospital Infantil Universitario Niño Jesús (Madrid))
Camacho, Marisol (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Navarro Gómez, María Luisa (Hospital General Universitario Gregorio Marañón)
Oltra Benavent, Manuel (Hospital Universitari i Politècnic La Fe (València))
Giralt, Gemma (Hospital Universitari Vall d'Hebron)
Bustillo, Matilde (Hospital Universitario Miguel Servet (Saragossa))
Bello Naranjo, Ana María (Department of Pediatrics, Hospital Universitario Materno-Infantil de Las Palmas de Gran Canaria)
Rocandio, Beatriz (Hospital Universitario de Donostia (Sant Sebastià, País Basc))
Rodríguez-González, Moisés (Hospital Universitario Puerta del Mar (Cadis, Andalusia))
Núñez Cuadros, Esmeralda (Hospital Regional Universitario de Málaga)
Aracil Santos, Javier (Hospital Universitario La Paz (Madrid))
Moreno, David (Hospital Regional Universitario de Málaga)
Calvo, Cristina (Hospital Universitario La Paz (Madrid))
Universitat Autònoma de Barcelona

Data:	2021
Resum:	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.
Ajuts:	Ministerio de Ciencia e Innovación CM19-00015
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Kawasaki disease (KD) ; Children ; SARS-CoV-2 ; COVID-19 ; Shock ; Multisystem inflammatory syndrome in children (MIS-C) ; Pediatric inflammatory multisystem syndrome (PIMS-TS)
Publicat a:	Frontiers in Pediatrics, Vol. 8 (january 2021) , ISSN 2296-2360

DOI: 10.3389/fped.2020.617039
PMID: 33537269

18 p, 1.5 MB

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