Sumera Afzal*, Azka Ali, Alejandra Guadalupe Ponce Alvizo, Sumayya Umar, Angel Neupane, Mohamed Abbassy, Jose Antonio Gomez Miranda, Qasim Sahibzada Muhammad, Hamza Yunus, Ashim Kandel, Anupa Shrestha, Chet Bahadur Ranabhat, Syed Burhanuddin Khadri, Mujtaba Zafar and Jennifer A. Maldonado


The incidence of Kawasaki disease (KD) has significantly increased since the outbreak of coronavirus disease 2019 (COVID -19) pandemic across the globe, posing a major challenge among pediatricians and health care authorities. COVID-19 is currently recognized as a multisystem disorder that can cause systemic vasculitis which shares clinical features of Kawasaki disease and reflects a particularly strong immunological reaction described as an inflammatory multisystem syndrome (MIS-C) in children with lab evidence of SARS-CoV-2. The main features of cytokine syndrome include high fever, multi-organ dysfunction, and inflammation with clinical features that mimic Kawasaki Disease, toxic shock, and macrophage activation syndrome (MAS) requiring pediatric intensive care admissions for circulatory support. The evidence from various studies suggested that COVID-19 can trigger Kawasaki-like disease. However, much remains to be understood about the potential association between covid-19 and increasing incidence of Kawasaki disease-like features as the disease process is still unclear. This review highlights the need to screen Covid-19 in patients diagnosed with classic Kawasaki disease. Recommended guidelines should be followed along with administration of intravenous immunoglobulins (IVIG), IV methylprednisolone, IL-6, and IL-1 inhibitors in midst of the COVID-19 pandemic as early as possible to decrease the frequency of coronary artery lesions.

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