SARS-CoV-2–Induced Kawasaki-Like Hyperinflammatory Syndrome: A Novel COVID Phenotype in Children

American Academy of Pediatrics (AAP) - Tập 146 Số 2 - 2020
Francesco Licciardi1,2, Giulia Pruccoli1, Marco Denina1,2, Emilia Parodi1,2, Manuela Taglietto2, Sergio Rosati3, Davide Montin1,2
1Department of Pediatric and Public Health Sciences, University of Torino, Turin, Italy;
2Regina Margherita Children’s Hospital, AOU Città della Salute e della Scienza di Torino, Turin, Italy
3Department of Veterinary Sciences, University of Turin, Turin, Italy; and

Tóm tắt

We describe 2 children with persistent fever and profuse diarrhea who developed signs of mucocutaneous involvement (conjunctivitis, fissured lips, skin rash, erythema, and edema of the hands and feet). Blood tests revealed elevated markers of inflammation, lymphopenia, thrombocytopenia, and complement consumption. Afterward, diffuse edema with hypoalbuminemia appeared in the context of a capillary leak syndrome. In both patients, repeated nasal swabs were negative for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but each patient had high titers of immunoglobulin G and immunoglobulin M against the SARS-CoV-2 virus. The negative PCR results in the presence of immunoglobulin M and immunoglobulin G suggested that the inflammatory response developed in the late phase of viral infection, when SARS-CoV-2 was not detectable in the upper airway. In this report, we describe patients with what we propose to name as SARS-CoV-2–induced Kawasaki-like hyperinflammatory syndrome. SARS-CoV-2–induced Kawasaki-like hyperinflammatory syndrome seems to be caused by a delayed response to SARS-CoV-2. It resembles Kawasaki disease complicated by macrophage activation syndrome, although it has peculiar features, such as prodromal diarrhea, capillary leak syndrome, and myocardial dysfunction. Intravenous corticosteroid treatment appears to be helpful.

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American Academy of Pediatrics (AAP)

Tập 146 Số 2

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