Paediatric multisystem inflammatory syndrome associated with COVID-19: filling the gap between myocarditis and Kawasaki?
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ORIGINAL ARTICLE
Paediatric multisystem inflammatory syndrome associated with COVID-19: filling the gap between myocarditis and Kawasaki? Jeanne Bordet 1 & Stéphanie Perrier 2 & Catherine Olexa 1,2 & Anne-Cécile Gerout 3 & Philippe Billaud 2 & Laurent Bonnemains 1,2,4 Received: 13 July 2020 / Revised: 28 August 2020 / Accepted: 10 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Myocarditis and Kawasaki disease are common but usually distinct diseases in children. During the coronavirus pandemic (COVID-19), reports of a new form of myocarditis with clinical features of Kawasaki appeared. We investigated the place of this new disease in the spectrum encompassing Kawasaki disease and myocarditis. Thirty two consecutive children referred to our centre for a suspicion of Kawasaki or a diagnosis of myocarditis were included and eventually divided into four groups: 11 Kawasaki diseases, 6 Kawasaki syndromes (children with another diagnosis), 7 myocarditis without Kawasaki clinical feature and 7 myocarditis with incomplete Kawasaki clinical features. All were treated with immunoglobulins except those of the myocarditis group. The survival rate was 91%. The 7 children with myocarditis and clinical features of incomplete Kawasaki were all positive for SARS-CoV-2. They had a transient myocardial failure with a favourable course and none had coronary artery disease. Conclusion: Every COVID-19 child within our population had a mild to severe myocarditis and presented with fever plus two or three Kawasaki clinical features. Short-term evolution was good for these children. This new disease seems to fill the gap between isolated myocarditis and Kawasaki disease.
What is Known: • A new paediatric disease close to Kawasaki disease appeared during the COVID-19 pandemic What is New: • In our population, children presented with fever, vivid Kawasaki clinical features (although the Kawasaki syndrome was always incomplete) and a myocarditis without coronary abnormalities. • The new disease fills the gap between paediatric myocarditis and Kawasaki disease but its prognosis is much better.
Keywords Kawasaki disease . Myocarditis . Paediatric vascularitis . COVID-19 . SARS-COV-2
* Laurent Bonnemains [email protected]
Philippe Billaud [email protected]
Jeanne Bordet [email protected]
1
Stéphanie Perrier [email protected]
Cardiologie infantile, CHU Hautepierre, Strasbourg University Hospital, 1 rue de Molière, 67200 Strasbourg, France
2
Catherine Olexa [email protected]
Cardiac Surgery, New Civil Hospital, Strasbourg University Hospital, rue de l’Hopital, 67000 Strasbourg, France
3
Anne-Cécile Gerout [email protected]
Pharmacy, CHU Hautepierre, Strasbourg University Hospital, 1 rue de Molière, 67200 Strasbourg, France
4
iCube – UMR 7357, 2 rue Boussingault, 67000 Strasbourg, France
Eur J Pediatr
Abbreviations COVID-19 CT ICD-10 PCR SARS-CoV-2
Coronavirus disease 2019 Computed tomograph
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