From: COVID-19 in children: an approach for multisystem inflammatory syndrome
Characteristics | Kawasaki disease | Multisystem inflammatory syndrome in children |
---|---|---|
Age of presentation | Less than 5 years | Children aged 8–10 years |
Gender | Male > female | Male > female |
Fever | Present | Present |
Cutaneous sign | Seen in most patients | Seen in < 50% of patients |
Lymphadenopathy | More common | Not common |
Hemodynamic instability and ICU support | Less than 5% of patients develop shock syndrome | Present in almost all patients |
Cardiovascular complication | Symptomatic myocarditis is not common | Cardiac dysfunction is seen at presentation; severe myocarditis and pericarditis are more common |
Predominant symptoms | Gastrointestinal symptoms are not prominent | Gastrointestinal manifestations (abdominal pain, diarrhea) present in > 80% patients |
Inflammatory markers | Neutrophilic leukocytosis is usual | Lymphopenia is common; cytokine storm is more severe; extremely high levels of N-terminal brain natriuretic peptide, Troponins and D-dimer |
Organ dysfunction | Multiorgan dysfunction is not common | Multiorgan dysfunction seen |
Etiology | No identifiable cause | Post-infectious syndrome. SARS-CoV-2 serology is usually positive; in seronegative patients, there is usually history of contact with an individual having COVID-19 infection |
Management | Intravenous immunoglobulin; steroid; interleukin-1 blockers | Intravenous immunoglobulin; steroids; interleukin-1 blockers; interleukin-6 inhibitors |