Kawasaki-like multisystem inflammatory syndrome in children during the covid-19 pandemic in Paris, France: prospective observational study
By J. Toubiana, Clément Poirault, A. Corsia, F. Bajolle, J. Fourgeaud, F. Angoulvant, Agathe Debray, Romain Basmaci, E. Salvador, S. Biscardi and 5 more. British medical journal, 2020
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Abstract Objectives To describe the characteristics of children and adolescents affected by an outbreak of Kawasaki-like multisystem inflammatory syndrome and to evaluate a potential temporal association with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Design Prospective observational study. Setting General paediatric department of a university hospital in Paris, France. Participants 21 children and adolescents (aged ≤18 years) with features of Kawasaki disease who were admitted to hospital between 27 April and 11 May 2020 and followed up until discharge by 15 May 2020. Main outcome measures The primary outcomes were clinical and biological data, imaging and echocardiographic findings, treatment, and outcomes. Nasopharyngeal swabs were prospectively tested for SARS-CoV-2 using reverse transcription-polymerase chain reaction (RT-PCR) and blood samples were tested for IgG antibodies to the virus. Results 21 children and adolescents (median age 7.9 (range 3.7-16.6) years) were admitted with features of Kawasaki disease over a 15 day period, with 12 (57%) of African ancestry. 12 (57%) presented with Kawasaki disease shock syndrome and 16 (76%) with myocarditis. 17 (81%) required intensive care support. All 21 patients had noticeable gastrointestinal symptoms during the early stage of illness and high levels of inflammatory markers. 19 (90%) had evidence of recent SARS-CoV-2 infection (positive RT-PCR result in 8/21, positive IgG antibody detection in 19/21). All 21 patients received intravenous immunoglobulin and 10 (48%) also received corticosteroids. The clinical outcome was favourable in all patients. Moderate coronary artery dilations were detected in 5 (24%) of the patients during hospital stay. By 15 May 2020, after 8 (5-17) days of hospital stay, all patients were discharged home. Conclusions The ongoing outbreak of Kawasaki-like multisystem inflammatory syndrome among children and adolescents in the Paris area might be related to SARS-CoV-2. In this study an unusually high proportion of the affected children and adolescents had gastrointestinal symptoms, Kawasaki disease shock syndrome, and were of African ancestry.
Subfields: Infectious Diseases, Obstetrics and Gynecology, Surgery
View Paper: https://www.semanticscholar.org/paper/39d56bba484bfad743e9081c4a4e51eba8c22de3
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Citations in the corpus
- Multisystem Inflammatory Syndrome in U.S. Children and Adolescents (2020, neutral): “Still hospitalized as of May 20, 2020 26 (36) 19 (33) 7 (13) 52 (28)”
- Endothelial Dysfunction in Atherosclerotic Cardiovascular Diseases and Beyond: From Mechanism to Pharmacotherapies (2021, background): “Liu F, Zhu Y, Zhang J, Li Y, and Peng Z (2020a) Intravenous high-dose vitamin C for the treatment of severe COVID-19: study protocol for a multicentre randomised controlled trial.”
- COVID-19 and multisystem inflammatory syndrome in children and adolescents (2020, positive): “Gruber and colleagues 91 also reported the presence of autoantibodies against endo thelial, gastro intestinal, and immune cells in patients with MISC. Antibodies to SARSCoV might accentuate disease through antibodydependent enhancement of viral entry and amplification of viral replication, as ob”
- Teacher Wellbeing During a Pandemic: Surviving or Thriving? (2020, background): “Most alarmingly, and in contrast to most public messaging as to the impacts of the virus on children and young adults, the new coronavirus has been linked to a deadly new Kawasakilike illness in children (Amirfakhryan, 2020; Toubiana et al., 2020; Viner & Whittaker, 2020).”