ABSTRACT
Kawasaki disease is an acute, self-limiting vasculitis in children. Early treatment is necessary to prevent cardiovascular complications. The acute phase of Kawasaki disease may present with hemodynamic instability. An association between viral respiratory infections and Kawasaki disease has been reported. Studies have shown that Kawasaki and Kawasaki-like disease may be associated with and have symptoms overlapping COVID-19. Children with COVID-19 may present as Kawasaki-like disease with pediatric inflammatory multisystem syndrome, or macrophage activation syndrome. Clinicians need to be aware of the early diagnosis and management of Kawasaki disease to prevent the development of coronary artery aneurysms. The symptoms overlap of multisystem inflammatory disease seen in COVID-19 adds to the difficulties in timely diagnosis and treatment. Children with Kawasaki disease require regular follow-up plans for coronary artery aneurysms. This adds to the difficulties during the changed environment of COVID-19 for control and prevention. Missed diagnosis and early treatment of Kawasaki disease with immunoglobulin and aspirin results in the development of coronary artery aneurysm in up to 25% of cases, with grave consequences. Here, we briefly review the management of typical and atypical Kawasaki disease which has symptoms overlapping with the multisystem inflammatory disease as seen in COVID-19.
Subject(s)
COVID-19 , Mucocutaneous Lymph Node Syndrome , Child , Humans , Mucocutaneous Lymph Node Syndrome/complications , Mucocutaneous Lymph Node Syndrome/diagnosis , Mucocutaneous Lymph Node Syndrome/drug therapy , SARS-CoV-2 , Systemic Inflammatory Response SyndromeABSTRACT
The cases of coronavirusdisease 2019 in children have been increasing with the ongoing pandemic.The finding suggests children have mild symptoms and a short course of the disease. Angiotensinconverting enzyme-2 mediates entry of the virus into the cell, the combination of virus and ACE2 leads to an increase in activity of angiotensin II, resulting in acute injury to lungs, myocardium and other organs. The infection causes down-regulation of ACE2 expression. The ACE2 plays an important role in the infection progression and clinical characteristics of COVID-19. Works on ACE2 and virus spike protein have future prospects of strategic information on prevention, management as well as vaccine development. Keywords: children;Coronavirus Disease 2019(COVID-19);SARS-Cov-2;angiotensin-Converting Enzyme 2 (ACE2).