Understanding Kawasaki Disease and COVID-19

Many respiratory diseases like influenza affect children in large numbers.

So far, the reported number of COVID-19 cases in children is low compared to other age groups. Many children who get COVID-19 experience milder symptoms, although they also can be carriers of the coronavirus.

A small number of children with COVID-19 have also developed a serious inflammatory condition. The condition affects multiple systems, including the heart, blood vessels, and eyes.

Known as “pediatric multi-system inflammatory syndrome,” it is treatable, but it can cause serious illness or death. It is thought to be triggered by the body’s immune response to the coronavirus.

The condition has symptoms similar to those of Kawasaki disease, a rare childhood illness that affects the blood vessels. Some children with Kawasaki disease have gotten COVID-19. However, there are differences between Kawasaki disease and this new condition.

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What Are the Symptoms of Pediatric Multi-System Inflammatory Syndrome?

According to reports, many children who develop pediatric multi-system inflammatory syndrome don’t show common COVID-19 respiratory symptoms like fever, cough, and shortness of breath.

Children with this condition develop other symptoms, including:

  • Persistent high fever
  • Inflammation
  • Evidence of dysfunction in one or more organs (shock, cardiac, respiratory, renal, gastrointestinal, or neurological disorder)
  • Low blood pressure
  • Enlarged coronary arteries
  • Abdominal pain
  • Rash
  • Trouble breathing
  • Vomiting or diarrhea
  • Conjunctivitis
  • Swollen hands or feet
  • Coronary aneurysms

Children with the condition may or may not test positive for the coronavirus, according to the Royal College of Paediatrics and Children’s Health. Others may have COVID-19 antibodies, indicating prior infection with coronavirus.

The cause of the condition is unknown, although it may be a post-infection response by the children’s bodies.

COVID-19 and Kawasaki Disease

Pediatric multi-system inflammatory syndrome has some similar symptoms to Kawasaki disease, including fever, raised rashes, and swollen hands and feet.

However, the two conditions aren’t completely the same.

Symptoms like abdominal pain, vomiting, and diarrhea aren’t common in Kawasaki disease but have presented in some children with the new condition. Shock is also rare with Kawasaki disease but more common with the new syndrome.

Also, Kawasaki disease generally affects children under 5 years old, while pediatric multi-system inflammatory syndrome can affect any age, including older children and adolescents. The new syndrome appears to affect all demographics, while Kawasaki disease is more common in people of Asian descent.

How Is Pediatric Multi-System Inflammation Syndrome Treated?

Early recognition by pediatricians and referral to specialists is important to treat pediatric multi-system inflammation syndrome.

Treatment generally depends on the severity of symptoms. For milder cases, treatment may include supportive care of symptoms. However, children’s symptoms should be constantly monitored to determine if treatment should change.

Treatments include:

  • Steroids
  • High-dose aspirin
  • Antibiotics
  • IV immunoglobin
  • Oxygen treatments

Children with severe breathing trouble may need a ventilator until their breathing improves.

What Should I Do If My Child Is Sick?

Pediatric multi-system inflammation syndrome is a rare condition. However, you should monitor your child for symptoms like fever, abdominal pain, nausea, vomiting, rash, or swelling in the hands and feet. If you notice these or other symptoms, call your child’s doctor for advice.

If your child is experiencing life-threatening symptoms, including a persistent high fever or severe breathing problems, call 911 or visit the nearest emergency department.

Also, you should continue to monitor your children for respiratory symptoms of COVID-19, including fever, cough, and shortness of breath.

You should also follow COVID-19 prevention practices like regular handwashing, cleaning commonly touched items, and social distancing. All children over 2 years old should wear facemasks in public.

For more information, call UPMC Children’s Hospital of Pittsburgh at 412-692-5325 or visit us online.

Sources

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American Heart Association, What Is Kawasaki Disease? Link

Ariana Eunjung Cha and Chelsea Janes, Children Are Falling Ill With Perplexing Inflammatory Syndrome Thought to Be Linked to COVID-19. The Washington Post. Link

Maria Godoy. Mystery Inflammatory Syndrome In Kids And Teens Likely Linked To COVID-19. NPR. Link

Andrew Jacobs and Edgar Sandoval, Mysterious Coronavirus Illness Claims 3 Children in New York. The New York Times. Link

New York Department of Health, Health Advisory: Pediatric Multi-System Inflammatory Syndrome Potentially Associated With Coronavirus Disease (COVID-19) in Children. Link

Royal College of Paediatrics and Child Health, Guidance: Paediatric Multisystem Inflammatory Syndrome Temporally Associated With COVID-19. Link

About Pediatrics

From nutrition to illnesses, from athletics to school, children will face many challenges growing up. Parents often will make important health care decisions for them. We hope to help guide both of you in that journey. UPMC Children’s Hospital of Pittsburgh ranks No. 8 on U.S. News & World Report’s Best Children’s Hospitals Honor Roll. All 10 of our specialties rank nationally. UPMC Magee-Womens Hospital is a longtime national leader for women and their newborns. We aim to provide the best care for your children, from birth to adulthood and beyond.