Characterizing the differences between multisystem inflammatory syndrome in children and Kawasaki disease

Sci Rep. 2021 Jul 5;11(1):13840. doi: 10.1038/s41598-021-93389-0.

Abstract

To characterize the new SARS-Co-V-2 related multisystem inflammatory syndrome in children (MIS-C) among Israeli children and to compare it with Kawasaki disease (KD). We compared, in two medical centers, the clinical and laboratory characteristics of MIS-C, KD and an intermediate group, which met the case definitions of both conditions. MIS-C patients were older, were more likely to be hypotensive, to have significant gastrointestinal symptoms, lymphopenia and thrombocytopenia and to have non-coronary abnormal findings in their echocardiogram. Lymphopenia was an independent predictor of MIS-C. Most of our MIS-C patients responded promptly to corticosteroid therapy. KD incidence in both centers was similar in 2019 and 2020. Although there is clinical overlap between KD and MIS-C, these are separate entities. Lymphopenia clearly differentiates between these entities. MIS-C patients may benefit from corticosteroids as first-line therapy.

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • COVID-19 / complications*
  • COVID-19 / diagnosis
  • COVID-19 / pathology*
  • COVID-19 / virology
  • COVID-19 Drug Treatment
  • Child
  • Child, Preschool
  • Diagnosis, Differential
  • Female
  • Humans
  • Lymphopenia / diagnosis
  • Lymphopenia / pathology*
  • Male
  • Mucocutaneous Lymph Node Syndrome / diagnosis*
  • Mucocutaneous Lymph Node Syndrome / drug therapy
  • Mucocutaneous Lymph Node Syndrome / pathology
  • Mucocutaneous Lymph Node Syndrome / virology
  • Risk Factors
  • SARS-CoV-2 / pathogenicity
  • Systemic Inflammatory Response Syndrome / diagnosis*
  • Systemic Inflammatory Response Syndrome / drug therapy
  • Systemic Inflammatory Response Syndrome / pathology
  • Systemic Inflammatory Response Syndrome / virology
  • Young Adult

Substances

  • Adrenal Cortex Hormones

Supplementary concepts

  • pediatric multisystem inflammatory disease, COVID-19 related