Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Apr;41(3):526-535.
doi: 10.1007/s10875-020-00941-0. Epub 2021 Jan 4.

Distinctive Features of Kawasaki Disease Following SARS-CoV-2 Infection: a Controlled Study in Paris, France

Julie Toubiana  1   2 , Jérémie F Cohen  3   4 , Joséphine Brice  3 , Clément Poirault  3 , Fanny Bajolle  5 , William Curtis  6 , Florence Moulin  7 , Soraya Matczak  3   8 , Marianne Leruez  9 , Jean-Laurent Casanova  10   11 , Martin Chalumeau  3   4 , Melissa Taylor  3 , Slimane Allali  3
Affiliations

Distinctive Features of Kawasaki Disease Following SARS-CoV-2 Infection: a Controlled Study in Paris, France

Julie Toubiana et al. J Clin Immunol. 2021 Apr.

Abstract

Background: An outbreak of multisystem inflammatory syndrome in children, including Kawasaki disease (KD), emerged during COVID-19 pandemic. We explored whether Kawasaki-like disease (KD), when associated with confirmed SARS-CoV-2 infection, has specific characteristics.

Methods: We included children and adolescents with KD criteria admitted in the department of general pediatrics of a university hospital in Paris, France, between January 1, 2018, and May 26, 2020. The incidence of KD was compared between the outbreak and a pre-outbreak control period (January 1, 2018, to April 25). Characteristics of patients with positive SARS-CoV-2 testing (KD-SARS-CoV-2) were compared to those of the pre-outbreak period (classic KD).

Results: A total of 30 and 59 children with KD were admitted during the outbreak and pre-outbreak periods, respectively (incidence ratio 13.2 [8.3-21.0]). During the outbreak, 23/30 (77%) children were diagnosed as KD-SARS-CoV-2. When compared with patients with classic KD, those with KD-SARS-CoV-2 were more frequently of sub-Saharan African ancestry (OR 4.4 [1.6-12.6]) and older (median 8.2 vs. 4.0 years, p < 0.001), had more often initial gastrointestinal (OR 84 [4.9-1456]) and neurological (OR 7.3 [1.9-27.7] manifestations, and shock syndrome (OR 13.7 [4.2-45.1]). They had significantly higher CRP and ferritin levels. Noticeably, they had more frequently myocarditis (OR 387 [38-3933]).

Conclusions: Children and adolescents with KD-SARS-CoV-2 have specific features when compared with those with classic KD. These findings should raise awareness and facilitate the study of their pathogenesis.

Keywords: COVID-19; Kawasaki disease; MIS-C; PIMS-TS; SARS-CoV-2.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Frequency of Kawasaki disease at the general pediatric department of Necker Hospital for Sick Children, Paris, France, between January 1, 2018, and May 26, 2020 (2-week periods)
Fig. 2
Fig. 2
Comparison of biological features between patients with KD-SARS-CoV-2 and patients with classic KD. Group 1 corresponded to “classic KD,” i.e., children with KD admitted between January 1, 2018, and April 25, 2020. Group 2 corresponded to “KD-SARS-CoV-2,” i.e., children admitted between April 26, 2020, and May 26, 2020, with positive SARS-CoV-2 (PCR and/or serology) testing. Group 3 corresponded to “KD-non-SARS-CoV-2,” i.e., children admitted between April 26, 2020, and May 26, 2020, with negative SARS-CoV-2 (PCR and serology) testing
See this image and copyright information in PMC

References

    1. Coronavirus disease WHO. (COVID-19) situation report–77. Geneva. Switzerland: World Health Organization; 2019. p. 2020.
    1. Salje H, Tran Kiem C, Lefrancq N, et al. Estimating the burden of SARS-CoV-2 in France. Science. 2020. 10.1126/science.abc3517. - PMC - PubMed
    1. Fontanet A, Tondeur L, Madec L, et al. Cluster of COVID-19 in northern France: a retrospective closed cohort study. medRxiv 2020;10.1101/2020.04.18.20071134 [Preprint].
    1. Castagnoli R, Votto M, Licari A, et al. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children and adolescents: a systematic review. JAMA Pediatr. 2020. 10.1001/jamapediatrics.2020.1467. - PubMed
    1. Gudbjartsson DF, Helgason A, Jonsson H, Magnusson OT, Melsted P, Norddahl GL, Saemundsdottir J, Sigurdsson A, Sulem P, Agustsdottir AB, Eiriksdottir B, Fridriksdottir R, Gardarsdottir EE, Georgsson G, Gretarsdottir OS, Gudmundsson KR, Gunnarsdottir TR, Gylfason A, Holm H, Jensson BO, Jonasdottir A, Jonsson F, Josefsdottir KS, Kristjansson T, Magnusdottir DN, le Roux L, Sigmundsdottir G, Sveinbjornsson G, Sveinsdottir KE, Sveinsdottir M, Thorarensen EA, Thorbjornsson B, Löve A, Masson G, Jonsdottir I, Möller AD, Gudnason T, Kristinsson KG, Thorsteinsdottir U, Stefansson K. Spread of SARS-CoV-2 in the Icelandic population. N Engl J Med. 2020;382(24):2302–2315. doi: 10.1056/NEJMoa2006100. - DOI - PMC - PubMed