Falah Noor Ul, Hashmi Shahnawaz, Ahmed Zahoor, Jaan Ali, Akhtar Ali, Khalid Farhan, Farooque Umar, Shera Muhammad Tayyab, Ali Sundas, Javed Ayesha
Internal Medicine, Mayo Hospital, King Edward Medical University, Lahore, PAK.
Internal Medicine, Army Medical College, National University of Medical Sciences, Rawalpindi, PAK.
Cureus. 2020 Oct 19;12(10):e11035. doi: 10.7759/cureus.11035.
Children with coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), usually present with symptoms of mild upper respiratory tract infection without developing any significant complications. However, this observation has been rendered incautious by hundreds of clinical cases from around the world that have depicted a less benign multisystem inflammatory illness mimicking Kawasaki disease in COVID-positive pediatric patients. Our study aimed at retrospectively reviewing the different features of Kawasaki disease-like illness in children suffering from COVID-19, including the complications, laboratory investigations, treatment strategies used during their hospital stay, and outcomes. We searched the electronic database of the two pediatric units of Mayo Hospital, Lahore, Pakistan, for children who had been admitted to the ward between April 2020 and July 2020 and were diagnosed with COVID-19. A total of 10 such pediatric cases were found, whose clinical details were then reviewed and the obtained data were presented in the form of tables and percentages. The median age was between 4 months to 11 years (mean: 6 years). Of the 10 patients, 8 (80%) were boys. Criteria for Kawasaki disease were met in all of them (100%), with a complete presentation in five (50%). Fever (100%), conjunctival and oral cavity changes (90%), and rash (80%) were the most common features. Seven (70%) patients required admission to a critical care unit, but no mortality occurred. This article can assist in understanding and dealing with Kawasaki disease-like manifestation of pediatric COVID-19 infection, especially in critical care settings, and its possible complications. It will help in a timely and appropriate decision-making regarding treatment and management of such cases.
2019冠状病毒病（COVID-19）由严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）引起，患病儿童通常表现为轻度上呼吸道感染症状，不会出现任何严重并发症。然而，来自世界各地的数百例临床病例表明，COVID-19阳性儿科患者中出现了一种不那么良性的多系统炎症性疾病，类似于川崎病，这使得上述观察结果变得不那么谨慎。我们的研究旨在回顾性分析COVID-19患儿川崎病样疾病的不同特征，包括并发症、实验室检查、住院期间使用的治疗策略以及预后。我们在巴基斯坦拉合尔梅奥医院两个儿科病房的电子数据库中搜索了2020年4月至2020年7月期间入院并被诊断为COVID-19的儿童。共发现10例此类儿科病例，随后对其临床细节进行了回顾，并以表格和百分比的形式呈现了所获得的数据。中位年龄在4个月至11岁之间（平均：6岁）。10例患者中，8例（80%）为男孩。所有患者（100%）均符合川崎病标准，其中5例（50%）为完全型。发热（100%）、结膜和口腔改变（90%）以及皮疹（80%）是最常见的特征。7例（70%）患者需要入住重症监护病房，但无死亡病例。本文有助于理解和处理儿科COVID-19感染的川崎病样表现，尤其是在重症监护环境中，以及其可能的并发症。它将有助于对此类病例的治疗和管理做出及时、恰当的决策。
