medwireNews: Italian researchers report a 30-fold increase in the incidence of severe Kawasaki-like disease with the emergence of COVID-19.
Lorenzo D’Antiga (Hospital Papa Giovanni XXIII, Bergamo) and co-authors say that 10 children were diagnosed with Kawasaki disease at their center between 18 February and 20 April 2020, compared with just 19 in the previous 5-year period, giving incidence rates of 10.0 versus 0.3 per month.
For pediatric rheumatologists, this potential for causative agents in Kawasaki could be a breakthrough in understanding this complex disease
Click here for the view of editorial board member Sangeeta Sule.
In addition to having a significantly higher disease incidence, the researchers say that patients diagnosed during the COVID-19 pandemic had different clinical and biochemical features to those diagnosed previously. For instance, children from the 2020 cohort were significantly older on average (7.5 vs 3.0 years), and had “respiratory and gastrointestinal involvement, meningeal signs, and signs of cardiovascular involvement.” The 2020 cohort also had significantly lower lymphocyte and platelet counts, and higher ferritin levels, compared with the earlier cohort, and 80% had positive serologic test results for SARS-CoV-2 antibodies.
Therefore, “[t]he SARS-CoV-2 epidemic was associated with high incidence of a severe form of Kawasaki disease,” which “might present outside the classic Kawasaki disease phenotype,” write D’Antiga and team in The Lancet.
Noting that “[t]his condition might be serious and requires prompt and more aggressive management,” the team says that “[f]uture research on the cause of Kawasaki disease and similar syndromes should focus on immune responses to viral triggers.”
medwireNews is an independent medical news service provided by Springer Healthcare. © 2020 Springer Healthcare part of the Springer Nature Group
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