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Kawasaki-like multisystem inflammatory syndrome in children during the covid-19 pandemic in Paris, France : prospective observational study

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

OBJECTIVES: To describe the characteristics of children and adolescents affected by an outbreak of Kawasaki-like multisystem inflammatory syndrome and to evaluate a potential temporal association with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection

DESIGN: Prospective observational study

SETTING: General paediatric department of a university hospital in Paris, France

PARTICIPANTS: 21 children and adolescents (aged ≤18 years) with features of Kawasaki disease who were admitted to hospital between 27 April and 11 May 2020 and followed up until discharge by 15 May 2020

MAIN OUTCOME MEASURES: The primary outcomes were clinical and biological data, imaging and echocardiographic findings, treatment, and outcomes. Nasopharyngeal swabs were prospectively tested for SARS-CoV-2 using reverse transcription-polymerase chain reaction (RT-PCR) and blood samples were tested for IgG antibodies to the virus

RESULTS: 21 children and adolescents (median age 7.9 (range 3.7-16.6) years) were admitted with features of Kawasaki disease over a 15 day period, with 12 (57%) of African ancestry. 12 (57%) presented with Kawasaki disease shock syndrome and 16 (76%) with myocarditis. 17 (81%) required intensive care support. All 21 patients had noticeable gastrointestinal symptoms during the early stage of illness and high levels of inflammatory markers. 19 (90%) had evidence of recent SARS-CoV-2 infection (positive RT-PCR result in 8/21, positive IgG antibody detection in 19/21). All 21 patients received intravenous immunoglobulin and 10 (48%) also received corticosteroids. The clinical outcome was favourable in all patients. Moderate coronary artery dilations were detected in 5... Full description

Comment in: Nat Rev Immunol. 2020 Jul;20(7):407. - PMID 32461672
Year of Publication: 2020
Contained in: BMJ (Clinical research ed.) Vol. 369 (2020), p. m2094
All journal articles: Search for all articles in this journal
Language: English
Contributors: Toubiana, Julie | Author
Poirault, Clément
Corsia, Alice
Bajolle, Fanny
Fourgeaud, Jacques
Angoulvant, François
Debray, Agathe
Basmaci, Romain
Salvador, Elodie
Biscardi, Sandra
Frange, Pierre
Chalumeau, Martin
Casanova, Jean-Laurent
Cohen, Jérémie F
Allali, Slimane
Full text access:
Electronic availability is being checked...
Links: Full Text (dx.doi.org)
Keywords: Journal Article
Observational Study
Additional Keywords: Adolescent
Adrenal Cortex Hormones
Antibodies, Viral
Betacoronavirus
Child
Child, Preschool
Coronavirus Infections
Female
Humans
Immunoglobulins, Intravenous
Male
Nasopharynx
Pandemics
Paris
Pneumonia, Viral
Prospective Studies
RNA, Viral
Systemic Inflammatory Response Syndrome
ISSN: 1756-1833
Note: Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Notes: Date Completed 16.06.2020
Date Revised 16.06.2020
published: Electronic
CommentIn: Nat Rev Immunol. 2020 Jul;20(7):407. - PMID 32461672
Citation Status MEDLINE
Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
PMID:
    32493739
Physical Description: Online-Ressource
ID (e.g. DOI, URN): 10.1136/bmj.m2094
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520 |a © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. 
520 |a OBJECTIVES: To describe the characteristics of children and adolescents affected by an outbreak of Kawasaki-like multisystem inflammatory syndrome and to evaluate a potential temporal association with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection 
520 |a DESIGN: Prospective observational study 
520 |a SETTING: General paediatric department of a university hospital in Paris, France 
520 |a PARTICIPANTS: 21 children and adolescents (aged ≤18 years) with features of Kawasaki disease who were admitted to hospital between 27 April and 11 May 2020 and followed up until discharge by 15 May 2020 
520 |a MAIN OUTCOME MEASURES: The primary outcomes were clinical and biological data, imaging and echocardiographic findings, treatment, and outcomes. Nasopharyngeal swabs were prospectively tested for SARS-CoV-2 using reverse transcription-polymerase chain reaction (RT-PCR) and blood samples were tested for IgG antibodies to the virus 
520 |a RESULTS: 21 children and adolescents (median age 7.9 (range 3.7-16.6) years) were admitted with features of Kawasaki disease over a 15 day period, with 12 (57%) of African ancestry. 12 (57%) presented with Kawasaki disease shock syndrome and 16 (76%) with myocarditis. 17 (81%) required intensive care support. All 21 patients had noticeable gastrointestinal symptoms during the early stage of illness and high levels of inflammatory markers. 19 (90%) had evidence of recent SARS-CoV-2 infection (positive RT-PCR result in 8/21, positive IgG antibody detection in 19/21). All 21 patients received intravenous immunoglobulin and 10 (48%) also received corticosteroids. The clinical outcome was favourable in all patients. Moderate coronary artery dilations were detected in 5 (24%) of the patients during hospital stay. By 15 May 2020, after 8 (5-17) days of hospital stay, all patients were discharged home 
520 |a CONCLUSIONS: The ongoing outbreak of Kawasaki-like multisystem inflammatory syndrome among children and adolescents in the Paris area might be related to SARS-CoV-2. In this study an unusually high proportion of the affected children and adolescents had gastrointestinal symptoms, Kawasaki disease shock syndrome, and were of African ancestry 
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