MIS-C is likely to be distinct from Kawasaki disease based on current studies: a narrative review

ABSTRACT

Background and Objective: Children with SARS-CoV-2 infection were paid little attention to during the early stages of the outbreak because of low morbidity as well as mild clinical symptoms. Since late April 2020, reports regarding Kawasaki-like syndrome and hyperinflammatory response in children associated with COVID-19 have rapidly emerged. Till now, no certain relationship between multisystem inflammatory syndrome in Children (MIS-C) and Kawasaki Disease (KD) has been determined, which should be explored through continuous study. Methods: In order to synthesize key findings for the objectives of this review, we searched English literature published up to November 16, 2020 using PubMed with the following keywords Kawasaki disease 2020, Kawasaki-like disease, MIS-C, PIMS, PMIS and PIMS-TS. Key Content and Findings: Based on current researches, KD is regarded as an immune disorder induced by multiple unidentified pathogens, while MIS-C is confirmed to be associated with the infection of COVID-19. In addition, KD is popular in East Asian children under 3 years old, while MIS-C is reported more in older adolescents from Europe and North America. On the basis of multiple cohort studies, gastrointestinal symptoms, mechanical ventilation and inotropic support are more common in MIS-C. Instead, coronary arterial damage is more pronounced in KD. Moreover, the treatment regimen for MIS-C is more aggressive than KD because the cytokine storm is more violent and lasting. Conclusions: MIS-C is likely to be a distinct immunopathogenic illness associated with SARS-CoV-2 based on current studies, which could be used as a reference to help us better understand KD. In addition, MIS-C is an emerging syndrome for pediatricians, so the lack of relevant knowledge may result in under-diagnosis. Some individuals may fulfill full or partial criteria for KD but all should be reported if they meet the case definition for MIS-C. © 2022 AME Publishing Company. All right reserved.