COVID-19 associated pediatric vasculitis: A systematic review and detailed analysis of the pathogenesis.
Semin Arthritis Rheum
; 55: 152047, 2022 08.
Article
in English
| MEDLINE | ID: covidwho-1882505
ABSTRACT
OBJECTIVES:
Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2, has opened a new era in the practice of pediatric rheumatology since it has been associated with inflammatory complications such as vasculitis and arthritis. In this review, we aimed to present a detailed analysis of COVID-19 associated pediatric vasculitis.METHODS:
A systematic review of the English literature was performed through Pubmed/MEDLINE and Scopus up to January 1st, 2022. Articles including data about the patients with 1) onset of vasculitis <18 years of age, 2) evidence of SARS-CoV-2 exposure, 3) evidence of vasculitis diagnosis (imaging, histopathologic evidences or fulfilling the specific diagnostic/classification criteria) were included in the final analysis. Patients with Kawasaki disease-like vasculitis associated with multisystem inflammatory syndrome in children (MIS-C) were excluded.RESULTS:
A total of 25 articles describing 36 patients with COVID-19 associated pediatric vasculitis (median age 13 years; M/F 2.3) were included. The most frequent phenotype was IgA vasculitis (n=9) followed by chilblains (n=7) and ANCA associated vasculitis (AAV) (n=5). Skin (58.3%) and renal (30.5%) involvements were the most common manifestations of vasculitis. The majority of patients received corticosteroids (40%), while rituximab (14.2%) and cyclophosphamide (11.4%) were the most frequently used immunosuppressive drugs. Remission was achieved in 23 of 28 patients. Five patients (4 with central nervous system vasculitis; 1 with AAV) died.CONCLUSION:
Although COVID-19 associated pediatric vasculitis is very rare, awareness of this rare entity is important to secure earlier diagnosis and treatment. The clinical features of COVID-19 associated pediatric vasculitis subtypes look similar to those in pediatric vasculitis not associated with COVID-19. Whether COVID-19 is the reason of the vasculitis or only the trigger remains unknown.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
/
COVID-19
Type of study:
Prognostic study
/
Reviews
/
Systematic review/Meta Analysis
Topics:
Long Covid
Limits:
Child
/
Humans
Language:
English
Journal:
Semin Arthritis Rheum
Year:
2022
Document Type:
Article
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