Kawasaki disease is not linked to COVID-19 in Chinese pediatric population

Abstract

Increasing cases of children infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presenting with severe Kawasaki-like disease have recently been reported in some Western countries, raising the possibility of SARS-CoV-2 being a trigger of Kawasaki disease (KD). We aimed to investigate whether KD is linked to coronavirus disease 2019 (COVID-19) in Chinese pediatric population. Methods: Patients were enrolled if diagnosed with KD in the 40 hospitals of China Kawasaki Disease Research Collaborative Group from January to April 2020, the COVID-19 epidemic period in China. Information of demographic data, KD shock syndrome, macrophage activation syndrome (MAS), evidence of SARS-CoV-2 infection and the number of KD cases were retrospectively analyzed. Results: The completed response was received from 29/40 hospitals (72.5%) across 19 provinces. Of 2,108 KD patients enrolled, the median age was 1.9 years and 63.8% were male. KD shock syndrome and MAS were diagnosed in 8 (0.4%) and 2 (0.1%) patients, respectively, none of whom had contact history with COVID-19 patients. A greater number of KD cases from January to April 2020 than the upper limit of 95% confidence interval (95% CI) of estimated numbers of cases of the past 3 years were observed in only 2 out of 29 (6.9%) hospitals. Reverse transcription-polymerase chain reaction (RT-PCR) tests in 434 patients and antibody tests in 64 patients for SARS-CoV-2 were all negative, including nine with exposure history. Conclusions: There is no evidence of the link of KD with COVID-19 in Chinese children in terms of its prevalence and severity. © Pediatric Medicine. All rights reserved.