tetano
Editor, Senior Moderator
BMJ
. 2020 Jun 3;369:m2094.
doi: 10.1136/bmj.m2094.
Kawasaki-like Multisystem Inflammatory Syndrome in Children During the covid-19 Pandemic in Paris, France: Prospective Observational Study
Julie Toubiana[SUP] 1 2 [/SUP], Cl?ment Poirault[SUP] 1 [/SUP], Alice Corsia[SUP] 3 [/SUP], Fanny Bajolle[SUP] 4 [/SUP], Jacques Fourgeaud[SUP] 5 [/SUP], Fran?ois Angoulvant[SUP] 6 [/SUP], Agathe Debray[SUP] 1 [/SUP], Romain Basmaci[SUP] 7 [/SUP], Elodie Salvador[SUP] 3 [/SUP], Sandra Biscardi[SUP] 8 [/SUP], Pierre Frange[SUP] 9 [/SUP], Martin Chalumeau[SUP] 10 11 [/SUP], Jean-Laurent Casanova[SUP] 12 13 [/SUP], J?r?mie F Cohen[SUP] 1 11 [/SUP], Slimane Allali[SUP] 1 [/SUP]
Affiliations
Abstract
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 (24%) of the patients during hospital stay. By 15 May 2020, after 8 (5-17) days of hospital stay, all patients were discharged home.
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.
. 2020 Jun 3;369:m2094.
doi: 10.1136/bmj.m2094.
Kawasaki-like Multisystem Inflammatory Syndrome in Children During the covid-19 Pandemic in Paris, France: Prospective Observational Study
Julie Toubiana[SUP] 1 2 [/SUP], Cl?ment Poirault[SUP] 1 [/SUP], Alice Corsia[SUP] 3 [/SUP], Fanny Bajolle[SUP] 4 [/SUP], Jacques Fourgeaud[SUP] 5 [/SUP], Fran?ois Angoulvant[SUP] 6 [/SUP], Agathe Debray[SUP] 1 [/SUP], Romain Basmaci[SUP] 7 [/SUP], Elodie Salvador[SUP] 3 [/SUP], Sandra Biscardi[SUP] 8 [/SUP], Pierre Frange[SUP] 9 [/SUP], Martin Chalumeau[SUP] 10 11 [/SUP], Jean-Laurent Casanova[SUP] 12 13 [/SUP], J?r?mie F Cohen[SUP] 1 11 [/SUP], Slimane Allali[SUP] 1 [/SUP]
Affiliations
- PMID: 32493739
- DOI: 10.1136/bmj.m2094
Abstract
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 (24%) of the patients during hospital stay. By 15 May 2020, after 8 (5-17) days of hospital stay, all patients were discharged home.
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.