Kawasaki Disease in the Time of COVID-19 and MIS-C: The International Kawasaki Disease Registry.

Autor: Harahsheh AS; Division of Cardiology, Department of Pediatrics, Children's National Hospital; George Washington University School of Medicine and Health Sciences; Washington, DC, USA. Electronic address: aharahsh@childrensnational.org., Shah S; George Washington University School of Medicine and Health Sciences, Washington, DC, USA., Dallaire F; Department of Paediatrics, Université de Sherbrooke, and Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada., Manlhiot C; Blalock-Taussig-Thomas Congenital Heart Center at Johns Hopkins University, Baltimore, Maryland, USA., Khoury M; Division of Paediatric Cardiology, Department of Paediatrics, University of Alberta, Edmonton, Alberta, Canada., Lee S; The Heart Center at Nationwide Children's Hospital, Columbus, Ohio, USA., Fabi M; Paediatric Emergency Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy., Mauriello D; Johns Hopkins All Children's Hospital, Saint Petersburg, Florida, USA., Tierney ESS; Department of Pediatrics, Division of Cardiology, Lucile Packard Children's Hospital, Stanford University Medical Center, Palo Alto, California, USA., Sabati AA; Phoenix Children's Hospital, Phoenix, Arizona, USA., Dionne A; Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Dahdah N; Division of Paediatric Cardiology, CHU Ste-Justine, University of Montréal, Montréal, Québec, Canada., Choueiter N; Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York, USA., Thacker D; Nemours Children's Hospital, Wilmington, Delaware, USA., Giglia TM; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA., Truong DT; University of Utah and Primary Children's Hospital, Salt Lake City, Utah, USA., Jain S; New York Medical College/Maria Fareri Children's Hospital at Westchester Medical Center, Valhalla, New York, USA., Portman M; Seattle Children's Hospital, Seattle, Washington, USA., Orr WB; Division of Pediatric Cardiology, Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri, USA., Harris TH; UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA., Szmuszkovicz JR; Children's Hospital of Los Angeles, Los Angeles, California, USA., Farid P; Labatt Family Heart Centre, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada., McCrindle BW; Labatt Family Heart Centre, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
Jazyk: angličtina
Zdroj: The Canadian journal of cardiology [Can J Cardiol] 2024 Jan; Vol. 40 (1), pp. 58-72. Date of Electronic Publication: 2023 Jun 07.
DOI: 10.1016/j.cjca.2023.06.001
Abstrakt: Background: Patients with multisystem inflammatory syndrome in children (MIS-C) and Kawasaki disease (KD) have overlapping clinical features. We compared demographics, clinical presentation, management, and outcomes of patients according to evidence of previous SARS-CoV-2 infection.
Methods: The International Kawasaki Disease Registry (IKDR) enrolled KD and MIS-C patients from sites in North, Central, and South America, Europe, Asia, and the Middle East. Evidence of previous infection was defined as: Positive (household contact or positive polymerase chain reaction [PCR]/serology), Possible (suggestive clinical features of MIS-C and/or KD with negative PCR or serology but not both), Negative (negative PCR and serology and no known exposure), and Unknown (incomplete testing and no known exposure).
Results: Of 2345 enrolled patients SARS-CoV-2 status was Positive for 1541 (66%) patients, Possible for 89 (4%), Negative for 404 (17%) and Unknown for 311 (13%). Clinical outcomes varied significantly among the groups, with more patients in the Positive/Possible groups presenting with shock, having admission to intensive care, receiving inotropic support, and having longer hospital stays. Regarding cardiac abnormalities, patients in the Positive/Possible groups had a higher prevalence of left ventricular dysfunction, and patients in the Negative and Unknown groups had more severe coronary artery abnormalities.
Conclusions: There appears to be a spectrum of clinical features from MIS-C to KD with a great deal of heterogeneity, and one primary differentiating factor is evidence for previous acute SARS-CoV-2 infection/exposure. SARS-CoV-2 Positive/Possible patients had more severe presentations and required more intensive management, with a greater likelihood of ventricular dysfunction but less severe coronary artery adverse outcomes, in keeping with MIS-C.
(Copyright © 2023 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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