Association Between COVID‐19 and Kawasaki Disease: Vigilance Required From Otolaryngologists

Sandhaus, Henya; Crosby, Dana L.; Sharma, Arun; Gregory, Stacie

doi:10.1177/0194599820930238

Cited by 17 publications

(17 citation statements)

References 4 publications

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“…Its cutaneous manifestation is the polymorphic rash, and it presents, in addition to other symptoms, oral manifestations, such as erythema and edema on the tongue, lips, oral mucosa, lingual papillae, and cleft lip. KD has been identified simultaneously or shortly after confirmation of Covid-19 [36][37][38].…”

Section: Discussionmentioning

confidence: 99%

Oral and cutaneous manifestations of covid-19 in pediatric patients

Moraes

Natalino

Holanda

et al. 2021

RGO, Rev. Gaúch. Odontol.

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COVID-19 began in December 2019 in Wuhan City, China, and on March 11, 2020 it was classified by the World Health Organization as a pandemic. It is an asymptomatic infection that can progress to severe respiratory conditions. In adults, it is more prevalent, but is also observed in children, with the occurrence of extra respiratory symptoms, such as oral and cutaneous manifestations. This literature review aims to report the oral and cutaneous manifestations of COVID-19 in pediatric patients. The bibliographic search strategy was carried out in the PubMed, SciELO and Bireme databases on August 1, 2020, using MeSH Terms “COVID-19”; “Child”; “Oral Manifestations”; “Skin Manifestations”; “Ageusia”; “Dysgeusia” and corresponding Decs, and also manual search, without language restriction. The stages of search, screening, selection, evaluation of studies and data extraction were performed by four independent reviewers. Nine studies that met the eligibility criteria were identified. The most cited oral and cutaneous manifestations were, respectively, taste dysfunction in adolescents and erythematous eruption in extremities and trunk. Health professionals should be aware of these manifestations, however, this is a recent theme in the literature, and more careful studies with greater strength of evidence still need to be performed.

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Section: Discussionmentioning

confidence: 99%

Oral and cutaneous manifestations of covid-19 in pediatric patients

Moraes

Natalino

Holanda

et al. 2021

RGO, Rev. Gaúch. Odontol.

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“…According to the American Heart Association (AHA), its diagnosis involves persistent fever associated with five other criteria: oral mucosal changes, bilateral nonexudative conjunctivitis, exanthematous rash, flaking of hands and feet, and cervical lymphadenopathy. 7 Among its laboratory findings, anemia, leukocytosis, and thrombocytosis can be detected from the 7th day of fever, in addition to hypoalbuminemia and increased transaminases. Other complementary exams, such as echocardiography, can demonstrate coronary aneurysms or cardiac dysfunction (left ventricular function depression, mitral valve regurgitation or pericardial effusion).…”

Section: Discussionmentioning

confidence: 99%

“…4 Reports of complete recovery of cardiac function due to immunoglobulin therapy support the importance of early diagnosis and treatment. 7,9 The adjunctive use of steroids and anti-inflammatories has also been shown relevant in more critical features, such as MAS and KDSS, ensuring a better prognosis. Although multisystem inflammation syndrome is still rare, affecting about 0.1% of children exposed to Sars-CoV-2, it is important for the medical community to be aware of this new phenotype and its immunological mechanisms to anticipate the identification of the most severe cases.…”

Section: Discussionmentioning

confidence: 99%

Kawasaki-Like Disease, a New Phenotype in Sars-CoV-2?

Chara¹,

Rickli²,

Silva³

et al. 2021

International Journal of Cardiovascular Sciences

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The coronavirus disease , that assumed pandemic proportions in March 2020, mainly affects the respiratory tract, causing severe interstitial pneumonia in adults. Worldwide data indicate that COVID-19 tends to be more benign in children, which is evidenced by a high incidence of asymptomatic or mild upper airways' infection cases in this population. However, recent studies have been associating Kawasaki-like symptoms as a nonclassical presentation of coronavirus disease in pediatrics. It is suggested that the intense cytokine cascade, promoted by the SARS-CoV-2 infection, can trigger a multisystem inflammatory response as an atypical Kawasaki form in genetically predisposed individuals. In this context, patients may develop more severe clinical features with a greater predisposition to myocardial involvement, Macrophage Activation Syndrome, and Kawasaki Disease Shock Syndrome. Despite critical conditions, patients usually respond to conventional treatment of Kawasaki Disease with intravenous immunoglobulin. This article intends to provide an approach to the association between Kawasaki-Like Syndrome and COVID-19. BackgroundThe Sars-CoV-2 virus was initially isolated in the city of Wuhan, China, during a pneumonia outbreak of unknown cause in December 2019, a disease then named COVID-19. Due to its progressive worldwide spread, the World Health Organization decreed, three months later, the state of pandemic. 1 Sars-CoV-2 usually affects the respiratory tract, causing severe interstitial pneumonia in adults. In children, however, it tends to be more benign, manifesting asymptomatically or as a mild infection of upper airways. A systematic review that assessed a 12-case series of children from China found that 39%-82% of the patients with COVID-19 developed a moderate course of the disease. 2 A minority of pediatric cases presented severity, with respiratory failure, shock, coagulation dysfunction, and renal injury. 3,4 Data from many countries indicate that the rate of Sars-CoV-2 infection in the population under 18 is low, ranging from 1%-2%. Among the cases, the occurrence of unfavorable outcomes is even rarer. A cohort study by DeBiasi et al., 5 with 177 young patients diagnosed with coronavirus disease found that 44 (24.8%) patients needed hospitalization, among these, only 9 (2.8%) were critically ill. 5 Interestingly, one of them developed hypotension and myocardial depression associated with signs of hyperinflammatory state, a Kawasaki-like presentation. Despite being an unusual manifestation, the increase in the number of reported associations between Kawasaki Disease (KD) and COVID-19 in children raises new concerns about its consequences. 5,6 Search Methods: In order to develop a nonsystematic narrative review, we executed literature searches in multiple databases (Google Scholar, PubMed, SciELO, and Medscape) with no time restriction for articles published in English. Search terms included the keywords: "Sars-CoV-2", "COVID-19", "Kawasaki-like", "MIS-C", "PIMS-TS" and "Autoimmune disease". We emphasized i...

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“…For those who manifest myocarditis, echocardiographic monitoring is important at 1-2 and 4-6 weeks after the end of treatment. 24,32 As for other complications, treatment for MAS is usual and, if resistant, tumor necrosis factor inhibitor, immunosuppressive agents or therapeutic plasma exchange must be included. In KDSS, vasoactive drugs have to be associated.…”

Section: Treatmentmentioning

confidence: 99%

Clinical-Epidemiological Relation Between Sars-Cov-2 and Kawasaki Disease: An Integrative Literature

Santos¹,

Santos

Ribeiro³

2021

Rev. paul. pediatr.

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Objective: To analyze the current scientific literature to document, in an integrative review, the main findings that correlate Kawasaki disease (KD) to COVID-19. Data sources: The search was carried out in June 2020 in the following databases: Biblioteca Virtual em Saúde (BVS), periódico da CAPES and U.S National Library of Medicine (PubMed). The combination of descriptors used was [(COVID-19 OR SARS-CoV-2) AND (Kawasaki disease)], and the inclusion criteria stipulated were studies published from January 2019 to June 2020, without restriction of language or location, and available online in full. News, editorials, comments, and letters, as well as duplicates and articles that did not answer the guiding question were excluded. Data synthesis: A total of 97 articles were identified, of which seven comprised this review. The association of KD to the new coronavirus appears to trigger a severe clinical condition of vasculitis. Different from the usual, in this inflammatory syndrome, patients are older, and prevalence is higher in children from African or Caribbean ancestry; clinical and laboratory manifestations are also atypical, with a predominance of abdominal complaints and exaggerated elevation of inflammatory markers. In addition, there was a greater report of rare complications and greater resistance to the recommended treatment for KD. Conclusions: Pediatric COVID-19 and its potential association to severe KD, still unfamiliar to health professionals, reinforces the importance of testing patients with vasculitis for the new coronavirus and the need to wage high surveillance and preparation of the health system during the current pandemic.

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Association Between COVID‐19 and Kawasaki Disease: Vigilance Required From Otolaryngologists

Cited by 17 publications

References 4 publications

Oral and cutaneous manifestations of covid-19 in pediatric patients

Oral and cutaneous manifestations of covid-19 in pediatric patients

Kawasaki-Like Disease, a New Phenotype in Sars-CoV-2?

Clinical-Epidemiological Relation Between Sars-Cov-2 and Kawasaki Disease: An Integrative Literature

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