Kawasaki-like Syndrome as an Emerging Complication of SARS-CoV-2 Infection in Young Adults

  • César Burgi Vieira Unidade Funcional Medicina 2.4, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal http://orcid.org/0000-0003-3616-5440
  • Ana Teresa Ferreira Unidade Funcional Medicina 4, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
  • Filipa Botelho Cardoso Unidade Funcional Medicina 1.4, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
  • Jorge Pelicano Paulos Departamento de Anestesiologia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
  • Nuno Germano Unidade de Cuidados Intensivos Polivalente 7, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal

Keywords

COVID-19, Kawasaki syndrome, vasculitis, adult, multisystem inflammatory syndrome

Abstract

Background: Kawasaki-like syndrome occurring in children during the COVID-19 pandemic has been labelled multisystem inflammatory syndrome in children (MIS-C) by the CDC and paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 infection (PIMS-TS) by the ECDC. 
Case report: We report the case of an 18-year-old male patient presenting with a 72-hour history of abdominal pain, fever, erythematous skin rash, vomiting and diarrhoea. Examination showed he also had shock and he was first thought to have oedematous cholecystitis. SARS-CoV-2 infection was also diagnosed. He was admitted to the ICU, and echocardiography showed cardiac dysfunction, with a low ejection fraction and low cardiac index. High-sensitivity troponin serum levels were elevated. The patient received inotropic and vasopressor support. As he fulfilled several criteria for MIS-C/PIMS-TS, he was administered acetylsalicylic acid, corticosteroids and immunoglobulin, with a good clinical response.<br />
Conclusion: This case emphasizes how this severe presentation of COVID-19 can easily be misdiagnosed if the clinician is less aware of this syndrome in younger patients.

VIEW THE ENTIRE ARTICLE

References

Dong Y, Mo X, Hu Y, et al. Epidemiological characteristics of 2143 pediatric patients with 2019 coronavirus disease in China. Pediatrics 2020; doi: 10.1542/peds.2020-0702.

Kim GB. Reality of Kawasaki disease epidemiology. Korean J Pediatr 2019;62(8):292–296.

De Graeff N, Groot N, Ozen S, Eleftheriou D, Avcin T, Bader-Meunier B, et al. European consensus-based recommendations for the diagnosis and treatment of Kawasaki disease - the SHARE initiative. Rheumatology (Oxford) 2019;58(4):672–682.

Loomba R, Villarreal E, Flores S. COVID-19 and Kawasaki syndrome: should we really be surprised? Cardiol Young 2020 May 15:1–2.

CDC Health Alert Network. Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with Coronavirus Disease 2019. Available from: https://emergency.cdc.gov/han/2020/han00432.asp

European Centre for Disease Prevention and Control. Paediatric inflammatory multisystem syndrome and SARS-CoV-2 infection in children – 15 May 2020. ECDC: Stockholm; 2020. Available from: https://www.ecdc.europa.eu/en/publications-data/paediatric-inflammatory-multisystem-syndrome-and-sars-cov-2-rapid-risk-assessment

Published: 2020-09-10

Issue: Vol 7 No 10 (view)

Section: Articles

How to cite:
1.
Vieira CB, Ferreira AT, Cardoso FB, Paulos JP, Germano N. Kawasaki-like Syndrome as an Emerging Complication of SARS-CoV-2 Infection in Young Adults. EJCRIM 2020;7 doi:10.12890/2020_001886.

Most read articles by the same author(s)