Clinical Manifestation of Children with Kawasaki Disease during the COVID-19 Pandemic in Iran: A Case Series

Introduction: Kawasaki disease is a rare disease, but it is one of the most common childhood vasculitides. Given that the manifestations of Kawasaki disease overlap with acute infectious diseases such as COVID-19, timely identification of clinical symptoms and timely treatment in children with Kawasaki manifestations is essential to prevent acute and chronic complications in children. The aim of the present study was to investigate the various characteristics of Kawasaki disease in children during the COVID-19 pandemic.Methods: In this study, the records of all children with Kawasaki or Kawasaki-like disease admitted to Imam Sajjad (AS) Hospital in Ramsar were reviewed from the beginning of the COVID-19 pandemic between February 2020 and May 2023. The data were analyzed using the specific Kawasaki code in the discharge files and using the National Health Information System (HIS).Findings: In total, the various characteristics of 10 children with Kawasaki or Kawasaki-like disease were analyzed, and the data obtained were presented in the form of tables and percentages. The mean age ranged from 7 months to 8 years (mean: 3 years). Of the 10 patients, half were boys. Kawasaki disease criteria were observed in all (100%) of them (8 patients) and in the complete form in 6 patients (60%). Fever (100%), conjunctival and oral cavity changes (80%) in 8 patients, skin rash (80%) in 8 patients, and gastrointestinal symptoms (80%) in 8 patients were the most common symptoms. Pericarditis was observed in only 1 (10%) of the patients. The results of x-ray, CT-scan, and LP were positive for each in only 1 (10%) patient. The diagnosis of complete Kawasaki disease was observed in 6 (60%) patients and its incomplete form in 4 (40%) patients. 1 (10%) patient required intensive care unit admission, but there was no mortality.Conclusion: Timely diagnosis of Kawasaki disease in children with COVID-19 plays an effective role in treating and preventing its possible complications.

Clinical Manifestation of Children with Kawasaki Disease during the COVID-19 Pandemic in Iran: A Case Series Keywords:

COVID-19 , SARS-CoV-2 , Kawasaki disease , Multisystem inflammatory syndrome in children