Llinás-Caballero Kevin, Rodríguez Yhojan, Fernández-Sarmiento Jaime, Rodríguez-Jiménez Mónica, Anaya Juan-Manuel
Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia.
Department of Critical Care Medicine and Pediatrics, Universidad de La Sabana, Bogotá, Colombia.
Rev Colomb Reumatol. 2022 Jun;29:S66-S76. doi: 10.1016/j.rcreu.2020.11.004. Epub 2021 Jan 28.
Kawasaki disease (KD) is an acute vasculitis with multisystem involvement. Recently, the increasing incidence of a condition that closely resembles KD in many cases, named multisystem inflammatory syndrome in children (MIS-C), has set off alarms amid the current worldwide coronavirus disease-19 (COVID-19) pandemic. Hence, the aim is to conduct a systematic review of the literature about KD in Colombia and contrast it with COVID-19-related MIS-C.
A search was carried out in both international and Latin American electronic databases for publications concerning patients with KD in the Colombian population. Records were then screened by titles and/or abstracts, assessed for eligibility, and reviewed. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed. The search included studies reporting MIS-C associated with COVID-19, and compared these patients with our findings of KD in Colombia.
Out of 36 publications retrieved, 17 were included, representing 120 individuals. Male to female ratio was 1.6, and most patients (90.4%) were aged 5 years or less. Among the main features of KD, fever was the most frequent (96.2% of the patients), while cervical lymphadenopathy was present in only 40.6%. Intravenous immunoglobulin was administered in 91.4% cases and 6.2% were resistant. Cardiac involvement was found in around 30%, and 20% had coronary artery lesions. Comparison between MIS-C associated with COVID-19 and KD in Colombia indicates that patients affected by MIS-C were older (72.2% of MIS-C patients > 5 years), had higher rates of cardiac involvement, and required critical care more often.
Our findings of KD in Colombia are consistent with the available descriptions of KD in the scientific literature. Given the increasing rate of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in Colombia and Latin America, our study raises awareness about MIS-C in pediatric patients with COVID-19 and its relationship with KD.
川崎病（KD）是一种累及多系统的急性血管炎。最近，在全球范围内的新型冠状病毒肺炎（COVID-19）大流行期间，一种在许多方面与川崎病极为相似的病症——儿童多系统炎症综合征（MIS-C）发病率不断上升，这引发了人们的警惕。因此，本研究旨在对哥伦比亚关于川崎病的文献进行系统综述，并将其与COVID-19相关的MIS-C进行对比。
在国际和拉丁美洲电子数据库中检索有关哥伦比亚人群川崎病患者的出版物。然后通过标题和/或摘要对记录进行筛选，评估其是否符合条件并进行审查。遵循系统评价和Meta分析的首选报告项目（PRISMA）指南。检索包括报告与COVID-19相关的MIS-C的研究，并将这些患者与我们在哥伦比亚的川崎病研究结果进行比较。
在检索到的36篇出版物中，纳入了17篇，涉及120名个体。男女比例为1.6，大多数患者（90.4%）年龄在5岁及以下。在川崎病的主要特征中，发热最为常见（96.2%的患者），而颈部淋巴结肿大仅占40.6%。91.4%的病例使用了静脉注射免疫球蛋白，6.2%的病例对此耐药。约30%的患者有心脏受累，20%的患者有冠状动脉病变。哥伦比亚与COVID-19相关的MIS-C和川崎病的比较表明受MIS-C影响的患者年龄较大（72.2%的MIS-C患者>5岁），心脏受累率较高，且更常需要重症监护。
我们在哥伦比亚的川崎病研究结果与科学文献中对川崎病的现有描述一致。鉴于哥伦比亚和拉丁美洲严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染率不断上升，我们的研究提高了对COVID-19儿科患者中MIS-C及其与川崎病关系的认识。
