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. 2021 Jan 18:8:617039.
doi: 10.3389/fped.2020.617039. eCollection 2020.

Prevalence and Clinical Characteristics of SARS-CoV-2 Confirmed and Negative Kawasaki Disease Patients During the Pandemic in Spain

Elisa Fernández-Cooke  1   2 , Carlos D Grasa  3 , Sara Domínguez-Rodríguez  2 , Ana Barrios Tascón  4 , Judith Sánchez-Manubens  5 , Jordi Anton  5 , Beatriz Mercader  6 , Enrique Villalobos  7 , Marisol Camacho  8 , María Luisa Navarro Gómez  9 , Manuel Oltra Benavent  10 , Gemma Giralt  11 , Matilde Bustillo  12 , Ana María Bello Naranjo  13 , Beatriz Rocandio  14 , Moisés Rodríguez-González  15 , Esmeralda Núñez Cuadros  16 , Javier Aracil Santos  3 , David Moreno  16 , Cristina Calvo  3 ; KAWA-RACE Study Group
Affiliations

Prevalence and Clinical Characteristics of SARS-CoV-2 Confirmed and Negative Kawasaki Disease Patients During the Pandemic in Spain

Elisa Fernández-Cooke et al. Front Pediatr. .

Abstract

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 × 109) and platelet count (174 vs. 423 × 109/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.

Keywords: COVID-19; Kawasaki disease (KD); SARS-CoV-2; children; multisystem inflammatory syndrome in children (MIS-C); pediatric inflammatory multisystem syndrome (PIMS-TS); shock.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Trend in Kawasaki disease cases and PICU admissions from 1st March to 30th May during 2018–19 (preCoV-19p) and 2020 (CoV-19p).
Figure 2
Figure 2
Comparison of laboratory results of Kawasaki disease cases (2018–2019) vs. 2020 (CoV+).
Figure 3
Figure 3
Comparison of laboratory results of Kawasaki disease cases (2018–2019) vs. 2020 (CoV–).
See this image and copyright information in PMC

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