An adult with Kawasaki-like multisystem inflammatory syndrome associated with COVID-19

Clinicopathologic correlations of COVID-19–related cutaneous manifestations with special emphasis on histopathologic patterns

“…Of the 84 contributions accepted for our analysis, 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14. , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , ...…”

SARS-CoV-2 leads to a small vessel endotheliitis in the heart

“…We did not find typical changes of Kawasaki-disease in the main coronary arteries in our adult patients. To date, there are only two cases reported in adults in association with COVID-19-infection [ 72 , 73 ] and further studies are needed to clarify the association between COVID-19 and Kawasaki-disease.…”

Immune responses during COVID-19 infection

“…Furthermore, the increased incidence of Kawasaki disease in young children with COVID-19 infections, even in the absence of cardiovascular predisposition, is indicative of SARS-CoV-2 vascular tropism and vascular damage. 205 According to the Virshow Triad, abnormalities of the vascular endothelium, altered blood flow and abnormal platelet function lead to venous and arterial thrombosis in the event of COVID-19. 206 Pathological analysis have shown diffuse microthrombi surrounded by CD4 + T cells, macrophages and significant hemorrage called immunothrombosis.…”