Kawasaki Disease in the Time of COVID-19 and MIS-C : The International Kawasaki Disease Registry
Copyright © 2023 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved..
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.
| Errataetall: |
CommentIn: Can J Cardiol. 2024 Jan;40(1):73-76. - PMID 37451612 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:40 |
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| Enthalten in: |
The Canadian journal of cardiology - 40(2024), 1 vom: 28. Jan., Seite 58-72 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Harahsheh, Ashraf S [VerfasserIn] |
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| Anmerkungen: |
Date Completed 16.01.2024 Date Revised 08.03.2024 published: Print-Electronic CommentIn: Can J Cardiol. 2024 Jan;40(1):73-76. - PMID 37451612 Citation Status MEDLINE |
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| doi: |
10.1016/j.cjca.2023.06.001 |
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| Förderinstitution / Projekttitel: |
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NLM357923391 |
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| 100 | 1 | |a Harahsheh, Ashraf S |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Kawasaki Disease in the Time of COVID-19 and MIS-C |b The International Kawasaki Disease Registry |
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| 500 | |a CommentIn: Can J Cardiol. 2024 Jan;40(1):73-76. - PMID 37451612 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a 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 | ||
| 520 | |a 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) | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
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| 700 | 1 | |a Manlhiot, Cedric |e verfasserin |4 aut | |
| 700 | 1 | |a Khoury, Michael |e verfasserin |4 aut | |
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| 700 | 1 | |a Fabi, Marianna |e verfasserin |4 aut | |
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