Children with COVID-19 infection have experienced symptoms similar to Kawasaki disease due to multisystem inflammatory syndrome in children (MIS-C)
According to recent findings, some children with COVID-19 infection have experienced symptoms similar to Kawasaki disease (KD) due to COVID-19-related multisystem inflammatory syndrome in children (MIS-C).
This has sparked some debate about whether new cases indicate KD caused by the COVID-19 virus or MIS-C that resembles KD.
At the beginning of the pandemic, children were rarely reported to be infected, leading to the assumption that children were immune to the COVID-19 virus. However, as the pandemic has continued and led to families quarantining together at home, more children have been diagnosed with COVID-19, both symptomatic and asymptomatic.
What is Kawasaki disease?
Kawasaki disease is a type of medium-vessel vasculitis that affects only children. The condition causes inflammation of the blood vessels throughout the body.
Although no obvious cause has been established, several theories suggest that viral infections, such as COVID-19, can trigger the condition in genetically predisposed children.
Why is COVID-19 related to KD-like symptoms?
Studies have shown that children diagnosed with COVID-19 have developed symptoms comparable to Kawasaki disease or hyperinflammatory syndrome, including:
- Prolonged fever
- Changes in the lips and oral cavity
- Bilateral conjunctival injections
- Cervical lymphadenopathy
- Limb abnormalities
- Rashes
However, there are some differences between KD-like syndrome and KD, including faster progression of symptoms such as multisystem organ dysfunction along with a recent COVID-19 diagnosis. Patients with KD-like syndrome also have tachycardia and are more likely to experience cardiac or respiratory arrest. Primary investigations have shown that KD-like syndrome is linked to a worse outcome for patients.
While most MIS-C pediatric cases have no direct evidence of acute COVID-19 infection, many of them exhibited positive serological results, particularly a rise in immunoglobulin G (IgG), implying that MIS-C is a delayed immunological response to COVID-19. The lag time of 4-5 weeks in the pandemic curves of COVID-19 and MIS-C further support the idea that MIS-C is a post-infection symptom.
As a result, countries that are currently dealing with a COVID-19 outbreak should examine this unusual but life-threatening illness in children. Maintaining good personal hygiene, wearing a mask outside, social distancing, and vaccinating children against COVID-19 are all recommended.
COVID-19-related MIS-C vs. Kawasaki disease
Multisystem inflammatory syndrome in children (MIS-C) and Kawasaki disease (KD) share some clinical features, including:
- Febrile illness
- Blood vessel inflammation
- Potential for coronary artery aneurysms
MIS-C and KD also share symptoms such as:
- Fever
- Conjunctivitis
- Oropharyngeal congestion
However, since these nonspecific clinical features can be seen in a variety of other pediatric infectious illnesses, it is unclear whether or how much MIS-C and KD overlap. Age distribution, symptoms, cardiac involvement, inflammatory markers, treatment, and outcomes appear to be major differences between these two disorders.
