May 11, 2020
The SARS2 coronavirus may be triggering a version of an uncommon inflammatory condition called Kawasaki's disease in children. Kawasaki's disease is a troublesome vasculitis, inflammation of blood vessels, following a viral illness in young children. It is most often seen in young children aged less than 5 years old, but older children and adults can develop this disorder.
We see a case of Kawasaki's once or twice a decade. The incidence is somewhere around 1 in 8000 children.
The etiology is presumed to be viral, however, a clear link to any one virus has not been shown to date. Some of the current reported cases in NY were COVID positive by PCR and or antibody analysis but not all of them which is interesting. The illness begins with high fever that lasts for at least 5 days and is associated with:
1) red eyes, lips, and mouth
2) swollen, red hands and feet
3) enlarged lymph nodes
4) Irritability
In rare cases - after 10 days of symptoms, inflammation of the coronary arteries that supply the heart with blood and oxygen can occur. If these cardiac changes occur during the inflammatory stage of the illness, then the affected children present later as adults with arrhythmias, heart attacks and sudden death. (Burns et. al.1996) During the acute phase of the disease, we find the critical time to intervene with treatments aimed at reducing the inflammation and stopping the sequela from occurring. The COVID version of this illness appears to be a little different with some varying symptoms including organ failure and death.
If you see these symptoms in a young child, please seek care that can significantly reduce the long term risk of heart disease or other complications.
Dr. M
AHA Kawasaki's Article
Time Health Article
Burns J American College Cardiology Article
McCrindle Circulation Article
Dajani AHA Article
