Kawasaki Disease in the Time of COVID-19 and MIS-C: The International Kawasaki Disease Registry

International Kawasaki Disease Registry (IKDR); Ashraf S. Harahsheh; Samay Shah; Frederic Dallaire; Cedric Manlhiot; Michael Khoury; Simon Lee; Marianna Fabi; Daniel Mauriello; Elif Seda Selamet Tierney; Arash A. Sabati; Audrey Dionne; Nagib Dahdah; Nadine Choueiter; Deepika Thacker; Therese M. Giglia; Dongngan T. Truong; Supriya Jain; Michael Portman; William B. Orr; Tyler H. Harris; Jacqueline R. Szmuszkovicz; Pedrom Farid; Brian W. McCrindle; Mahmoud Alsalehi; Jean A. Ballweg; Benjamin Barnes; Elizabeth Braunlin; Ashley Buffone; Juan Carlos Bustamante-Ogando; Arthur J. Chang; Nicolas Corral; Paul Dancey; Mona El-Ganzoury; Nora El-Samman; Matthew Elias; Elisa Fernandez-Cooke; Kevin Friedman; Luis Martin Garrido-Garcia; Luis Martin Garrido; Guillermo Larios Goldenberg; Michelle M. Grcic; Kevin C. Harris; Mark D. Hicar; Bridgette Hindt; Pei Ni Jone; Hidemi Kajimoto; Kelli Kaneta; Manaswitha Khare; Stacie Knutson; Shelby Kutty; Marcello Lanari; Victoria Maksymiuk; Kimberly E. McHugh; Shae Merves; Nilanjana Misra; Sindhu Mohandas; Tapas Mondal; Kambiz Norozi; Todd Nowlen; Joseph J. Pagano; Deepa Prasad; Geetha Raghuveer; Prasad Ravi; Balasubramanian Sundaram; Anupam Sehgal; Ashish Shah; Belén Toral Vázquez; Adriana H. Tremoulet; Aishwarya Venkataraman; Laurence Watelle; Marco Antonio Yamazaki-Naksahimada; Anji T. Yetman

doi:10.1016/j.cjca.2023.06.001

Kawasaki Disease in the Time of COVID-19 and MIS-C: The International Kawasaki Disease Registry

International Kawasaki Disease Registry (IKDR), Ashraf S. Harahsheh, Samay Shah, Frederic Dallaire, Cedric Manlhiot, Michael Khoury, Simon Lee, Marianna Fabi, Daniel Mauriello, Elif Seda Selamet Tierney, Arash A. Sabati, Audrey Dionne, Nagib Dahdah, Nadine Choueiter, Deepika Thacker, Therese M. Giglia, Dongngan T. Truong, Supriya Jain, Michael Portman, William B. OrrTyler H. Harris, Jacqueline R. Szmuszkovicz, Pedrom Farid, Brian W. McCrindle, Mahmoud Alsalehi, Jean A. Ballweg, Benjamin Barnes, Elizabeth Braunlin, Ashley Buffone, Juan Carlos Bustamante-Ogando, Arthur J. Chang, Nicolas Corral, Paul Dancey, Mona El-Ganzoury, Nora El-Samman, Matthew Elias, Elisa Fernandez-Cooke, Kevin Friedman, Luis Martin Garrido-Garcia, Luis Martin Garrido, Guillermo Larios Goldenberg, Michelle M. Grcic, Kevin C. Harris, Mark D. Hicar, Bridgette Hindt, Pei Ni Jone, Hidemi Kajimoto, Kelli Kaneta, Manaswitha Khare, Stacie Knutson, Shelby Kutty, Marcello Lanari, Victoria Maksymiuk, Kimberly E. McHugh, Shae Merves, Nilanjana Misra, Sindhu Mohandas, Tapas Mondal, Kambiz Norozi, Todd Nowlen, Joseph J. Pagano, Deepa Prasad, Geetha Raghuveer, Prasad Ravi, Balasubramanian Sundaram, Anupam Sehgal, Ashish Shah, Belén Toral Vázquez, Adriana H. Tremoulet, Aishwarya Venkataraman, Laurence Watelle, Marco Antonio Yamazaki-Naksahimada, Anji T. Yetman

Research output: Contribution to journal › Article › peer-review

8 Scopus citations

Abstract

Background: Patients with multisystem inflammatory syndrome in children (MIS-C) and Kawasaki disease (KD) have overlapping clinical features. We compared demographics, clinical presentation, management, and outcomes of patients according to evidence of previous SARS-CoV-2 infection. Methods: The International Kawasaki Disease Registry (IKDR) enrolled KD and MIS-C patients from sites in North, Central, and South America, Europe, Asia, and the Middle East. Evidence of previous infection was defined as: Positive (household contact or positive polymerase chain reaction [PCR]/serology), Possible (suggestive clinical features of MIS-C and/or KD with negative PCR or serology but not both), Negative (negative PCR and serology and no known exposure), and Unknown (incomplete testing and no known exposure). Results: Of 2345 enrolled patients SARS-CoV-2 status was Positive for 1541 (66%) patients, Possible for 89 (4%), Negative for 404 (17%) and Unknown for 311 (13%). Clinical outcomes varied significantly among the groups, with more patients in the Positive/Possible groups presenting with shock, having admission to intensive care, receiving inotropic support, and having longer hospital stays. Regarding cardiac abnormalities, patients in the Positive/Possible groups had a higher prevalence of left ventricular dysfunction, and patients in the Negative and Unknown groups had more severe coronary artery abnormalities. Conclusions: There appears to be a spectrum of clinical features from MIS-C to KD with a great deal of heterogeneity, and one primary differentiating factor is evidence for previous acute SARS-CoV-2 infection/exposure. SARS-CoV-2 Positive/Possible patients had more severe presentations and required more intensive management, with a greater likelihood of ventricular dysfunction but less severe coronary artery adverse outcomes, in keeping with MIS-C.

Original language	English
Pages (from-to)	58-72
Number of pages	15
Journal	Canadian Journal of Cardiology
Volume	40
Issue number	1
DOIs	https://doi.org/10.1016/j.cjca.2023.06.001
State	Published - Jan 2024

Access to Document

10.1016/j.cjca.2023.06.001

Cite this

International Kawasaki Disease Registry (IKDR), Harahsheh, A. S., Shah, S., Dallaire, F., Manlhiot, C., Khoury, M., Lee, S., Fabi, M., Mauriello, D., Tierney, E. S. S., Sabati, A. A., Dionne, A., Dahdah, N., Choueiter, N., Thacker, D., Giglia, T. M., Truong, D. T., Jain, S., Portman, M., ... Yetman, A. T. (2024). Kawasaki Disease in the Time of COVID-19 and MIS-C: The International Kawasaki Disease Registry. Canadian Journal of Cardiology, 40(1), 58-72. https://doi.org/10.1016/j.cjca.2023.06.001

@article{e7dac1a378544d1d8db4d706eb503906,

title = "Kawasaki Disease in the Time of COVID-19 and MIS-C: The International Kawasaki Disease Registry",

abstract = "Background: Patients with multisystem inflammatory syndrome in children (MIS-C) and Kawasaki disease (KD) have overlapping clinical features. We compared demographics, clinical presentation, management, and outcomes of patients according to evidence of previous SARS-CoV-2 infection. Methods: The International Kawasaki Disease Registry (IKDR) enrolled KD and MIS-C patients from sites in North, Central, and South America, Europe, Asia, and the Middle East. Evidence of previous infection was defined as: Positive (household contact or positive polymerase chain reaction [PCR]/serology), Possible (suggestive clinical features of MIS-C and/or KD with negative PCR or serology but not both), Negative (negative PCR and serology and no known exposure), and Unknown (incomplete testing and no known exposure). Results: Of 2345 enrolled patients SARS-CoV-2 status was Positive for 1541 (66%) patients, Possible for 89 (4%), Negative for 404 (17%) and Unknown for 311 (13%). Clinical outcomes varied significantly among the groups, with more patients in the Positive/Possible groups presenting with shock, having admission to intensive care, receiving inotropic support, and having longer hospital stays. Regarding cardiac abnormalities, patients in the Positive/Possible groups had a higher prevalence of left ventricular dysfunction, and patients in the Negative and Unknown groups had more severe coronary artery abnormalities. Conclusions: There appears to be a spectrum of clinical features from MIS-C to KD with a great deal of heterogeneity, and one primary differentiating factor is evidence for previous acute SARS-CoV-2 infection/exposure. SARS-CoV-2 Positive/Possible patients had more severe presentations and required more intensive management, with a greater likelihood of ventricular dysfunction but less severe coronary artery adverse outcomes, in keeping with MIS-C.",

author = "{International Kawasaki Disease Registry (IKDR)} and Harahsheh, {Ashraf S.} and Samay Shah and Frederic Dallaire and Cedric Manlhiot and Michael Khoury and Simon Lee and Marianna Fabi and Daniel Mauriello and Tierney, {Elif Seda Selamet} and Sabati, {Arash A.} and Audrey Dionne and Nagib Dahdah and Nadine Choueiter and Deepika Thacker and Giglia, {Therese M.} and Truong, {Dongngan T.} and Supriya Jain and Michael Portman and Orr, {William B.} and Harris, {Tyler H.} and Szmuszkovicz, {Jacqueline R.} and Pedrom Farid and McCrindle, {Brian W.} and Mahmoud Alsalehi and Ballweg, {Jean A.} and Benjamin Barnes and Elizabeth Braunlin and Ashley Buffone and Bustamante-Ogando, {Juan Carlos} and Chang, {Arthur J.} and Nicolas Corral and Paul Dancey and Mona El-Ganzoury and Nora El-Samman and Matthew Elias and Elisa Fernandez-Cooke and Kevin Friedman and Garrido-Garcia, {Luis Martin} and Garrido, {Luis Martin} and Goldenberg, {Guillermo Larios} and Grcic, {Michelle M.} and Harris, {Kevin C.} and Hicar, {Mark D.} and Bridgette Hindt and Jone, {Pei Ni} and Hidemi Kajimoto and Kelli Kaneta and Manaswitha Khare and Stacie Knutson and Shelby Kutty and Marcello Lanari and Victoria Maksymiuk and McHugh, {Kimberly E.} and Shae Merves and Nilanjana Misra and Sindhu Mohandas and Tapas Mondal and Kambiz Norozi and Todd Nowlen and Pagano, {Joseph J.} and Deepa Prasad and Geetha Raghuveer and Prasad Ravi and Balasubramanian Sundaram and Anupam Sehgal and Ashish Shah and V{\'a}zquez, {Bel{\'e}n Toral} and Tremoulet, {Adriana H.} and Aishwarya Venkataraman and Laurence Watelle and Yamazaki-Naksahimada, {Marco Antonio} and Yetman, {Anji T.}",

note = "Publisher Copyright: {\textcopyright} 2023 Canadian Cardiovascular Society",

year = "2024",

month = jan,

doi = "10.1016/j.cjca.2023.06.001",

language = "English",

volume = "40",

pages = "58--72",

journal = "Canadian Journal of Cardiology",

issn = "0828-282X",

number = "1",

}

International Kawasaki Disease Registry (IKDR), Harahsheh, AS, Shah, S, Dallaire, F, Manlhiot, C, Khoury, M, Lee, S, Fabi, M, Mauriello, D, Tierney, ESS, Sabati, AA, Dionne, A, Dahdah, N, Choueiter, N, Thacker, D, Giglia, TM, Truong, DT, Jain, S, Portman, M, Orr, WB, Harris, TH, Szmuszkovicz, JR, Farid, P, McCrindle, BW, Alsalehi, M, Ballweg, JA, Barnes, B, Braunlin, E, Buffone, A, Bustamante-Ogando, JC, Chang, AJ, Corral, N, Dancey, P, El-Ganzoury, M, El-Samman, N, Elias, M, Fernandez-Cooke, E, Friedman, K, Garrido-Garcia, LM, Garrido, LM, Goldenberg, GL, Grcic, MM, Harris, KC, Hicar, MD, Hindt, B, Jone, PN, Kajimoto, H, Kaneta, K, Khare, M, Knutson, S, Kutty, S, Lanari, M, Maksymiuk, V, McHugh, KE, Merves, S, Misra, N, Mohandas, S, Mondal, T, Norozi, K, Nowlen, T, Pagano, JJ, Prasad, D, Raghuveer, G, Ravi, P, Sundaram, B, Sehgal, A, Shah, A, Vázquez, BT, Tremoulet, AH, Venkataraman, A, Watelle, L, Yamazaki-Naksahimada, MA & Yetman, AT 2024, 'Kawasaki Disease in the Time of COVID-19 and MIS-C: The International Kawasaki Disease Registry', Canadian Journal of Cardiology, vol. 40, no. 1, pp. 58-72. https://doi.org/10.1016/j.cjca.2023.06.001

TY - JOUR

T1 - Kawasaki Disease in the Time of COVID-19 and MIS-C

T2 - The International Kawasaki Disease Registry

AU - International Kawasaki Disease Registry (IKDR)

AU - Harahsheh, Ashraf S.

AU - Shah, Samay

AU - Dallaire, Frederic

AU - Manlhiot, Cedric

AU - Khoury, Michael

AU - Lee, Simon

AU - Fabi, Marianna

AU - Mauriello, Daniel

AU - Tierney, Elif Seda Selamet

AU - Sabati, Arash A.

AU - Dionne, Audrey

AU - Dahdah, Nagib

AU - Choueiter, Nadine

AU - Thacker, Deepika

AU - Giglia, Therese M.

AU - Truong, Dongngan T.

AU - Jain, Supriya

AU - Portman, Michael

AU - Orr, William B.

AU - Harris, Tyler H.

AU - Szmuszkovicz, Jacqueline R.

AU - Farid, Pedrom

AU - McCrindle, Brian W.

AU - Alsalehi, Mahmoud

AU - Ballweg, Jean A.

AU - Barnes, Benjamin

AU - Braunlin, Elizabeth

AU - Buffone, Ashley

AU - Bustamante-Ogando, Juan Carlos

AU - Chang, Arthur J.

AU - Corral, Nicolas

AU - Dancey, Paul

AU - El-Ganzoury, Mona

AU - El-Samman, Nora

AU - Elias, Matthew

AU - Fernandez-Cooke, Elisa

AU - Friedman, Kevin

AU - Garrido-Garcia, Luis Martin

AU - Garrido, Luis Martin

AU - Goldenberg, Guillermo Larios

AU - Grcic, Michelle M.

AU - Harris, Kevin C.

AU - Hicar, Mark D.

AU - Hindt, Bridgette

AU - Jone, Pei Ni

AU - Kajimoto, Hidemi

AU - Kaneta, Kelli

AU - Khare, Manaswitha

AU - Knutson, Stacie

AU - Kutty, Shelby

AU - Lanari, Marcello

AU - Maksymiuk, Victoria

AU - McHugh, Kimberly E.

AU - Merves, Shae

AU - Misra, Nilanjana

AU - Mohandas, Sindhu

AU - Mondal, Tapas

AU - Norozi, Kambiz

AU - Nowlen, Todd

AU - Pagano, Joseph J.

AU - Prasad, Deepa

AU - Raghuveer, Geetha

AU - Ravi, Prasad

AU - Sundaram, Balasubramanian

AU - Sehgal, Anupam

AU - Shah, Ashish

AU - Vázquez, Belén Toral

AU - Tremoulet, Adriana H.

AU - Venkataraman, Aishwarya

AU - Watelle, Laurence

AU - Yamazaki-Naksahimada, Marco Antonio

AU - Yetman, Anji T.

PY - 2024/1

Y1 - 2024/1

N2 - Background: Patients with multisystem inflammatory syndrome in children (MIS-C) and Kawasaki disease (KD) have overlapping clinical features. We compared demographics, clinical presentation, management, and outcomes of patients according to evidence of previous SARS-CoV-2 infection. Methods: The International Kawasaki Disease Registry (IKDR) enrolled KD and MIS-C patients from sites in North, Central, and South America, Europe, Asia, and the Middle East. Evidence of previous infection was defined as: Positive (household contact or positive polymerase chain reaction [PCR]/serology), Possible (suggestive clinical features of MIS-C and/or KD with negative PCR or serology but not both), Negative (negative PCR and serology and no known exposure), and Unknown (incomplete testing and no known exposure). Results: Of 2345 enrolled patients SARS-CoV-2 status was Positive for 1541 (66%) patients, Possible for 89 (4%), Negative for 404 (17%) and Unknown for 311 (13%). Clinical outcomes varied significantly among the groups, with more patients in the Positive/Possible groups presenting with shock, having admission to intensive care, receiving inotropic support, and having longer hospital stays. Regarding cardiac abnormalities, patients in the Positive/Possible groups had a higher prevalence of left ventricular dysfunction, and patients in the Negative and Unknown groups had more severe coronary artery abnormalities. Conclusions: There appears to be a spectrum of clinical features from MIS-C to KD with a great deal of heterogeneity, and one primary differentiating factor is evidence for previous acute SARS-CoV-2 infection/exposure. SARS-CoV-2 Positive/Possible patients had more severe presentations and required more intensive management, with a greater likelihood of ventricular dysfunction but less severe coronary artery adverse outcomes, in keeping with MIS-C.

AB - Background: Patients with multisystem inflammatory syndrome in children (MIS-C) and Kawasaki disease (KD) have overlapping clinical features. We compared demographics, clinical presentation, management, and outcomes of patients according to evidence of previous SARS-CoV-2 infection. Methods: The International Kawasaki Disease Registry (IKDR) enrolled KD and MIS-C patients from sites in North, Central, and South America, Europe, Asia, and the Middle East. Evidence of previous infection was defined as: Positive (household contact or positive polymerase chain reaction [PCR]/serology), Possible (suggestive clinical features of MIS-C and/or KD with negative PCR or serology but not both), Negative (negative PCR and serology and no known exposure), and Unknown (incomplete testing and no known exposure). Results: Of 2345 enrolled patients SARS-CoV-2 status was Positive for 1541 (66%) patients, Possible for 89 (4%), Negative for 404 (17%) and Unknown for 311 (13%). Clinical outcomes varied significantly among the groups, with more patients in the Positive/Possible groups presenting with shock, having admission to intensive care, receiving inotropic support, and having longer hospital stays. Regarding cardiac abnormalities, patients in the Positive/Possible groups had a higher prevalence of left ventricular dysfunction, and patients in the Negative and Unknown groups had more severe coronary artery abnormalities. Conclusions: There appears to be a spectrum of clinical features from MIS-C to KD with a great deal of heterogeneity, and one primary differentiating factor is evidence for previous acute SARS-CoV-2 infection/exposure. SARS-CoV-2 Positive/Possible patients had more severe presentations and required more intensive management, with a greater likelihood of ventricular dysfunction but less severe coronary artery adverse outcomes, in keeping with MIS-C.

UR - http://www.scopus.com/inward/record.url?scp=85173139178&partnerID=8YFLogxK

U2 - 10.1016/j.cjca.2023.06.001

DO - 10.1016/j.cjca.2023.06.001

M3 - Article

C2 - 37290536

AN - SCOPUS:85173139178

SN - 0828-282X

VL - 40

SP - 58

EP - 72

JO - Canadian Journal of Cardiology

JF - Canadian Journal of Cardiology

IS - 1

ER -

Kawasaki Disease in the Time of COVID-19 and MIS-C: The International Kawasaki Disease Registry

Abstract

Access to Document

Other files and links

Fingerprint

Cite this