Kawasaki Disease and Covid- 19 – what is the link?

There has been a lot in the news recently about Kawasaki Disease (KD), especially regarding its possible link with COVID-19 disease.

 

This disease is called Pediatric Multisystem Inflammatory Syndrome (MIS-C).  This is especially frightening to parents as Kawasaki Disease can happen to previously healthy kids.  Because of the heart complications associated with KD, it is important to have kids with prolonged fevers (more than three days) evaluated by a provider familial with pediatric illnesses and how they show up in kids.

So what is Kawasaki Disease?  While some blood tests can aid in determining if kids have KD (there is no specific test for KD), the diagnosis of KD is made by listening to parents describe the symptoms and by a good exam by a pediatric practitioner.  Classically, kids are diagnosed with KD when they have a fever for 5 days (usually greater than 102 degrees and fever meds don’t always make the fever go away) AND five things:

  1. redness and cracking of the lips, strawberry tongue or red throat
  2. eye redness without discharge (i.e. no eye goop)
  3. rash
  4. redness and swelling of hands and feet (and  often redness and peeling of the groin)
  5. enlarged lymph node in the neck

The tricky part is that some kids don’t have all five things.  Also, many other illnesses are similar to Kawasaki Disease and have some of the same features.  That is why specific pediatric training and experience is really important.  You don’t want to miss the opportunity to treat KD as making the diagnosis can be life-saving!

The main reason that Kawasaki Disease is so worrisome is that is can cause several problems to the heart including dilation of the coronary arteries (arteries that supply needed blood and oxygen to the heart) and inflammation or fluid around the heart.  The good thing is that these things can usually be prevented with in-hospital treatment and medicines including intravenous immunoglobulin (IVIG) and aspirin. Many times, the prolonged fever goes away within hours if receiving IVIG, (although some kids need a second dose if the fever does not go away or the fever returns).

While Kawasaki Disease is still uncommon, it does occasionally occur in clusters.  At KidMed, we have had one case of COVID-related KD.  Most importantly, if your child does get some of these features, don’t panic.  However, it is important to have your child seen by a provider with specific pediatric training.  In my opinion, you have three choices for the best pediatric care- your pediatrician, a pediatric urgent care, or Pediatric ER.  As always, if you can’t be seen by your pediatrician, bring your child to KidMed to be seen by a pediatric specialist.

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