Trending Clinical Topic: Kawasaki Disease and COVID-19

Ryan Syrek

Disclosures

May 15, 2020

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Reports of a mysterious syndrome that may be associated with COVID-19 in children resulted in this week's top trending clinical topic. In New York, some children aged 2-15 years have exhibited unusual inflammatory symptoms associated with toxic shock or Kawasaki disease. Kawasaki disease is an acute febrile illness characterized by vasculitis of the medium-sized arteries, including coronary arteries. These same findings have been seen in children across Europe, including the United Kingdom, where an alert was issued by the National Health Service.

In response, UK pediatricians have published a working definition of the inflammatory syndrome. No one sign or symptom can be used to identify the children who are affected, and they may or may not test positive for COVID-19. At this time, the association between coronavirus infection and this hyperinflammatory state in children is not yet considered definitive but has been described as "plausible." Doctors have stated that the condition does not appear to be a result of the virus attacking the lungs.

Furthermore, although the symptoms of this presentation are Kawasaki-like, doctors stress that distinguishing that disease from this emerging constellation of symptoms is important in order to manage complications. Although shock is rarely associated with Kawasaki disease, many children with the inflammatory syndrome potentially related to coronavirus infection have low blood pressure, and their blood is unable to effectively support the body's organs. In an attempt to further assess the developing situation, the New York City Health Department released a bulletin, asking for any additional possible cases to be submitted.

Thus far, children appear to be affected less frequently by COVID-19, and those who are affected typically have milder symptoms. This is why the symptoms resembling Kawasaki disease have garnered so much attention. As with so many issues related to coronavirus infection, information regarding this inflammatory condition is still mostly anecdotal and under increasing investigation.

Read more about Kawasaki disease.

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