Kawasaki Disease and Multisystem Inflammatory Syndrome in Children with COVID-19
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COVID-19
Kawasaki Disease and Multisystem Inflammatory Syndrome in Children with COVID-19 Mojdeh Sarzaeim 1,2 & Nima Rezaei 1,2,3 Accepted: 28 September 2020 # Springer Nature Switzerland AG 2020
Abstract Since December 2019, the world has been exposed to a novel virus from the coronaviruses family, named coronavirus disease 2019 (COVID-19), which has affected the life of millions people around the world. This global pandemic causes a wide spectrum of clinical manifestation in children, adults, and elderly. One side of the spectrum in children is being asymptomatic and the other side is severe inflammatory symptoms. In this article, we describe the clinical manifestations, genetic background, and immune response of children with COVID-19, who are presented with severe multisystem inflammatory syndrome (MIS). Keywords Coronavirus disease . Inflammatory syndromes . Kawasaki disease . Pediatrics
Introduction Since the early twenty-first century, different species of Coronaviruses lead to three outbreaks, including severe acute respiratory syndrome (SARS) in 2002–2003, Middle East respiratory syndrome (MERS) in 2012, and more recently severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) [1, 2]. Other human coronaviruses that cause respiratory diseases are HKU1, OC43, NL63, and 229E. SARS-CoV-2 is a RNA genotype virus that is most closely related with about 90% nucleotide similarity to a group of SARS-like coronaviruses [3, 4]. The symptoms of first patients from China with novel coronavirus disease (COVID-19) were fever, dry cough, weakness, shortness of breath, and respiratory distress. Other symptoms like fatigue, anorexia, diarrhea, nausea, dizziness,
headache, vomiting, abdominal pain, various type of rashes, and conjunctivitis were also reported [5, 6]. Moreover lately, central nervous system involvement and myocarditis associated with SARS-CoV-2 have also been reported [7–10]. Although children were supposed to be less affected than adults [11], they are also at risk of infections at all ages, while the range of infection varies from asymptomatic to severe phenotypes. The immune system has a main role in fighting COVID-19, while it can also be affected during the infection, leading to severe complications and even death in those with immune dysregulation [12, 13]. Recently, a group of COVID19 positive test children present with multiple organ inflammatory symptoms that bears a striking resemblance to the inflammatory syndrome symptoms like Kawasaki disease (KD). A study in children and adolescents who had been infected by COVID-19 showed a high proportion in African race. They had presented with gastrointestinal symptom and KD shock syndrome [14].
This article is part of the Topical Collection on Covid-19 * Nima Rezaei [email protected] 1
Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
2
Research Center for Immunodeficiencies, Children’s Medical Center Hospital, Tehran University of Medical Science
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