Comparison of echocardiography results and disease complications in patients with Kawasaki and Kawasaki-like inflammatory syndrome with covid-۱۹

Introduction and Aim: One of the observed phenomena during the COVID-۱۹ pandemic is the occurrence of Multisystem Inflammatory Syndrome in Children and Adolescents (MIS-C). Patients with this disease have some overlapping symptoms and signs with Kawasaki Disease (KD). This disease is associated with cardiac complications. This study was conducted with the aim of comparing the results of echocardiography and cardiac complications in patients with Kawasaki and Kawasaki-like inflammatory syndrome affected by COVID-۱۹ referred to Mofid Hospital from ۲۰۲۰ to ۲۰۲۲. Materials and Methods: This cross-sectional analytical study was conducted on the research population of children hospitalized at Mofid Hospital with a diagnosis of COVID-۱۹ during the years ۲۰۲۰-۲۰۲۱. The clinical findings, echocardiographic results of patients, and cardiac complications were compared between the two groups of patients with Kawasaki and MIS-C. Results: ۲۲۷ patients with the final diagnosis of MIS-C or KD were investigated in this study. Among the patients, ۱۰۷ (۵۰.۵%) were girls and ۱۰۵ (۴۹.۵%) were boys. Of the patients, ۱۸۰ were MIS-C (۷۹.۳%) and ۴۷ were KD (۲۰.۷%), in terms of age, weight and body mass index, a significant difference was observed between the two groups (P<۰.۰۵). However, there was no statistically significant difference in the length of hospitalization between the two groups (P>۰.۰۵). In the laboratory investigations in the MIS-C and KD groups, a significant difference was observed in the levels of ESR, Uric-Asid, D-Dimer, P, Mg, WBC, PLT, MCV, BUN, Albumin and Total protein (p<۰.۰۵ ). The clinical manifestations of gastrointestinal and pulmonary involvement were significantly higher in the MIS-C group compared to KD (p<۰.۰۵). No statistical difference was observed in neurological, cardiac and skin involvement between the two groups (p>۰.۰۵). Also, no statistically significant difference was observed in the diagnostic indices between the two groups (P<۰.۰۵), in the results of the first echocardiography, pleural effusion and vascular involvement, in the second echocardiography, mild MR and pleural effusion were significantly different between the two groups, and other echocardiography results It was not significant in all three occasions (P>۰.۰۵). Conclusion: MIS-C likely represents a new systemic inflammatory syndrome associated with SARS-CoV-۲ infection in children, and MIS-C patients have cardiac complications. Further international studies are necessary to confirm these findings and better understand the pathophysiology of MIS-C.

کلیدواژه ها:

Multisystem inflammatory syndrome ، Kawasaki disease ، children ، COVID-۱۹