Oral manifestations of multisystemic inflammatory syndrome in children (MIS‐C) and Kawasaki disease associated to COVID‐19: A systematic review

Recent studies have shown that several children diagnosed with COVID-19 have developed Kawasaki Disease (KD)-like symptoms. This systematic review aims to assess the demographic, laboratory, and clinical characteristics of children with KD-like syndrome during the COVID-19 pandemic and evaluate efficacy of treatments and patients' outcome. A comprehensive search was carried out systematically through PubMed, Scopus, and Web of Science (WoS), medRxiv, and bioRxiv by two reviewers independently for all studies or preprints data on the demographic, laboratory, and clinical characteristics of children with K.D-like signs during the COVID-19 outbreak. Overall, 378 studies were identified by the systematic search, of which 25 studies were included in the study. The included studies involved 599 patients in total. Thirteen studies (52%) were case reports or case series, and the rest (48%) were cohort studies. In 19 studies, patients were diagnosed with Multisystem inflammatory syndrome in children (MIS-C). In 16 studies COVID-19 was diagnosed in all patients based on their polymerase chain reaction result, serological findings, and computed tomography results. Higher C-reactive protein and erythrocyte sedimentation rate level were the most prevalent laboratory findings. In most studies, patients had leucopenia with marked lymphopenia, hypoalbuminemia, and increased ferritin, as well as hyponatremia. Abnormal echocardiography and respiratory outcomes were the most common clinical outcomes. In 11 studies, all patients required intensive care unit admission. Findings of the present systematic review show that the incidence of KD-like syndrome in the COVID-19 pandemic increased significantly. Moreover, this study offers new insights in the KD-like syndrome pathogenesis and clinical spectrum during COVID-19 pandemic.

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Kawasaki disease in Colombia: A systematic review and contrast with multisystem inflammatory syndrome in children associated with COVID-19

Revista Colombiana de Reumatología ◽

10.1016/j.rcreu.2020.11.004 ◽

2021 ◽

Author(s):

Kevin Llinás-Caballero ◽

Yhojan Rodríguez ◽

Jaime Fernández-Sarmiento ◽

Mónica Rodríguez-Jiménez ◽

Juan-Manuel Anaya

Keyword(s):

Systematic Review ◽

Kawasaki Disease ◽

Inflammatory Syndrome

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Covid-19 and Autoimmune Diseases: A Systematic Review of Reported Cases

Current Rheumatology Reviews ◽

10.2174/1573397116666201029155856 ◽

2020 ◽

Vol 16 ◽

Author(s):

Mariam Ahmed Saad ◽

Mostafa Alfishawy ◽

Mahmoud Nassar ◽

Mahmoud Mohamed ◽

Ignatius N Esene ◽

...

Keyword(s):

Systematic Review ◽

Autoimmune Disease ◽

Kawasaki Disease ◽

Autoimmune Diseases ◽

English Language ◽

Clinical Evidence ◽

Eligibility Criteria ◽

Thrombocytopenic Purpura ◽

Pubmed Database ◽

Viral Illness

Introduction: Over 4.9 million cases of Coronavirus disease 2019 (COVID-19) have been confirmed since the worldwide pandemic began. Since the emergence of COVID-19, a number of confirmed cases reported autoimmune manifestations. Herein, we reviewed the reported COVID-19 cases with associated autoimmune manifestations. Methods: We searched PubMed database using all available keyword for COVID-19. All related studies between January 1st, 2020 to May 22nd, 2020 were reviewed. Only studies published in English language were considered. Articles were screened based on titles and abstract. All reports of confirmed COVID-19 patients who have associated clinical evidence of autoimmune disease were selected. Results: Among 10006 articles, searches yielded, Thirty-two relevant articles for full-text assessment. Twenty studies meet the eligibility criteria. The twenty eligible articles reported 33 cases of confirmed COVID-19 diagnosis who developed an autoimmune disease after the onset of covid-19 symptoms. Ages of patients varied from a 6 months old infant to 89 years old female (Mean=53.9 years of 28 cases); five cases had no information regarding their age. The time between symptoms of viral illness and onset of autoimmune symptoms ranged from 2 days to 33 days (Mean of the 33 cases=9.8 days). Autoimmune diseases were one case of subacute thyroiditis (3%), two cases of Kawasaki Disease (6.1%), three cases of coagulopathy and antiphospholipid syndrome (9.1%), three cases of immune thrombocytopenic purpura (9.1%), eight cases of autoimmune hemolytic anemia (24.2%), and sixteen cases of Guillain–Barré syndrome (48.5%). Conclusions: COVID-19 has been implicated in the development in a range of autoimmune diseases which may shed a light on the association between autoimmune diseases and infections.

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CD64, CD11a and CD18 leukocytes expression in children with SARS-CoV-2 multisystem inflammatory syndrome versus children with Kawasaki disease: Similar but not the same

Medicina Clínica ◽

10.1016/j.medcli.2020.09.002 ◽

2020 ◽

Author(s):

Alberto García-Salido ◽

Sandra Cuenca-Carcelén ◽

Ana Castillo-Robleda

Keyword(s):

Kawasaki Disease ◽

Inflammatory Syndrome

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Emerging Evidence on Multisystem Inflammatory Syndrome in Children Associated with SARS-CoV-2 Infection: a Systematic Review with Meta-analysis

SN Comprehensive Clinical Medicine ◽

10.1007/s42399-020-00690-6 ◽

2021 ◽

Author(s):

Mangla Sood ◽

Seema Sharma ◽

Ishaan Sood ◽

Kavya Sharma ◽

Ashlesha Kaushik

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Inflammatory Syndrome

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COVID‐19‐associated multisystem inflammatory syndrome in adults with Kawasaki disease‐like cutaneous manifestations

British Journal of Dermatology ◽

10.1111/bjd.20425 ◽

2021 ◽

Author(s):

M. Razmi T ◽

T.P. Afra ◽

T.P. Mohammed ◽

P.T.M. Ashik ◽

E. Sukesh

Keyword(s):

Kawasaki Disease ◽

Cutaneous Manifestations ◽

Inflammatory Syndrome

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Diversity of Cardiac and Gastrointestinal Presentations of Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19: A Case Series

Global Pediatric Health ◽

10.1177/2333794x21996613 ◽

2021 ◽

Vol 8 ◽

pp. 2333794X2199661

Author(s):

Anuja R. Shikhare ◽

Rimsha M. Iqbal ◽

Rabail Tariq ◽

Daniel R. Turner ◽

Bassam M. Gebara ◽

...

Keyword(s):

Kawasaki Disease ◽

Gastrointestinal Symptoms ◽

Case Series ◽

Asymptomatic Infection ◽

Cardiac Monitoring ◽

Delayed Presentation ◽

Terminal Ileitis ◽

Serologic Evidence ◽

Cardiac Manifestations ◽

Inflammatory Syndrome

COVID-19 is generally a benign or asymptomatic infection in children, but can occasionally be severe or fatal. Delayed presentation of COVID-19 with hyperinflammation and multi-organ involvement was recently recognized, designated the Multisystem Inflammatory Syndrome in Children (MIS-C). Six children with MIS-C with molecular and serologic evidence of SARS-CoV-2 infection were admitted to our hospital between May 5, 2020 and June 25, 2020. All had fever and weakness; 4/6 presented with gastrointestinal symptoms. Two children had features of complete Kawasaki disease, 3 had incomplete Kawasaki disease, while 1 had terminal ileitis with delayed onset of circulatory shock. Treatment consisted of intravenous immunoglobulin and aspirin for Kawasaki-like disease. Remdesivir, corticosteroids, and infliximab were used when indicated. Median hospitalization was 7 days. Immediate treatment resulted in rapid clinical improvement. In children presenting with hyperinflammatory syndromes without cardiac manifestations, testing for SARS-CoV-2 RNA and antibodies, with close cardiac monitoring should be pursued due to the manifold presentations of SARS-CoV-2 infection in children.

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A Systematic Review of Characteristics Associated with COVID-19 in Children with Typical Presentation and with Multisystem Inflammatory Syndrome

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18168269 ◽

2021 ◽

Vol 18 (16) ◽

pp. 8269

Author(s):

Jeffrey Kornitzer ◽

Jacklyn Johnson ◽

Max Yang ◽

Keith W. Pecor ◽

Nicholas Cohen ◽

...

Keyword(s):

Systematic Review ◽

Sore Throat ◽

Literature Search ◽

Clinical Presentation ◽

Pediatric Population ◽

Chinese Language ◽

Clinical Information ◽

Shortness Of Breath ◽

Global Pandemic ◽

Inflammatory Syndrome

Setting off a global pandemic, coronavirus disease 2019 (COVID-19) has been marked by a heterogeneous clinical presentation that runs the gamut from asymptomatic to severe and fatal. Although less lethal in children than adults, COVID-19 has nonetheless afflicted the pediatric population. This systematic review used clinical information from published literature to assess the spectrum of COVID-19 presentation in children, with special emphasis on characteristics associated with multisystem inflammatory syndrome (MIS-C). An electronic literature search for English and Chinese language articles in COVIDSeer, MEDLINE, and PubMed from 1 January 2020 through 1 March 2021 returned 579 records, of which 54 were included for full evaluation. Out of the total 4811 patients, 543 (11.29%) exhibited MIS-C. The most common symptoms across all children were fever and sore throat. Children presenting with MIS-C were less likely to exhibit sore throat and respiratory symptoms (i.e., cough, shortness of breath) compared to children without MIS-C. Inflammatory (e.g., rash, fever, and weakness) and gastrointestinal (e.g., nausea/vomiting and diarrhea) symptoms were present to a greater extent in children with both COVID-19 and MIS-C, suggesting that children testing positive for COVID-19 and exhibiting such symptoms should be evaluated for MIS-C.

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