Delineating phenotypes of Kawasaki disease and SARS-CoV-2-related inflammatory multisystem syndrome: a French study and literature review.
Rheumatology (Oxford)
; 60(10): 4530-4537, 2021 10 02.
Article
in English
| MEDLINE | ID: covidwho-1045829
ABSTRACT
OBJECTIVE:
To better define the clinical distinctions between the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related paediatric inflammatory multisystem syndrome (PIMS) and Kawasaki disease (KD).METHODS:
We compared three groups of patients group 1, cases from our national historic KD database (KD-HIS), before the SARS-CoV-2 pandemic; group 2, patients with KD admitted to an intensive care unit (KD-ICU) from both our original cohort and the literature, before the SARS-CoV-2 pandemic; and group 3, patients with PIMS from the literature.RESULTS:
KD-HIS included 425 patients [malefemale ratio 1.3, mean age 2.8 years (s.d. 2.4)], KD-ICU 176 patients [malefemale ratio 1.3, mean age 3.5 years (s.d. 3.1)] and PIMS 404 patients [malefemale ratio 1.4, mean age 8.8 years (s.d. 3.7)]. As compared with KD-HIS patients, KD-ICU and PIMS patients had a higher proportion of cardiac failure, digestive and neurological signs. KD-ICU and PIMS patients also had a lower frequency of typical KD-mucocutaneous signs, lower platelet count, higher CRP and lower sodium level. As compared with KD-HIS and KD-ICU patients, PIMS patients were older and more frequently had myocarditis; they also had fewer coronary abnormalities and lower sodium levels. Unresponsiveness to IVIG was more frequent in KD-ICU than KD-HIS and PIMS patients.CONCLUSION:
On clinical grounds, KD-HIS, KD-ICU and PIMS might belong to a common spectrum of non-specific pathogen-triggered hyperinflammatory states. The causes of increasing inflammation severity within the three entities and the different effects on the heart remain to be determined.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pericardial Effusion
/
Ventricular Dysfunction, Right
/
Ventricular Dysfunction, Left
/
Systemic Inflammatory Response Syndrome
/
Coronary Disease
/
COVID-19
/
Heart Failure
/
Mucocutaneous Lymph Node Syndrome
/
Myocarditis
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
/
Reviews
Topics:
Variants
Limits:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
/
Infant, Newborn
Country/Region as subject:
Europa
Language:
English
Journal:
Rheumatology (Oxford)
Journal subject:
Rheumatology
Year:
2021
Document Type:
Article
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