Kawasaki Disease Shock Syndrome vs Classical Kawasaki Disease: A Meta-analysis and Comparison With SARS-CoV-2 Multisystem Inflammatory Syndrome

被引:14
作者
Lamrani, Loubna [1 ,2 ]
Manlhiot, Cedric [3 ]
Elias, Matthew D. [4 ]
Choueiter, Nadine F. [5 ]
Dionne, Audrey [6 ]
Harahsheh, Ashraf S. [7 ]
Portman, Michael A. [8 ]
McCrindle, Brian W. [9 ]
Dahdah, Nagib [1 ]
机构
[1] Univ Montreal, CHU Ste Justine, Div Pediat Cardiol, Montreal, PQ, Canada
[2] McGill Univ, Sch Med, Montreal, PQ, Canada
[3] Johns Hopkins Univ, Dept Pediat, Baltimore, MD 21218 USA
[4] Childrens Hosp Philadelphia, Div Cardiol, 34th St & Civ Ctr Blvd, Philadelphia, PA 19104 USA
[5] Childrens Hosp Montefiore, Albert Einstein Coll Med, Bronx, NY USA
[6] Harvard Med Sch, Boston Childrens Hosp, Dept Pediat, Dept Cardiol, Boston, MA 02115 USA
[7] George Washington Univ, Natl Childrens Hosp, Sch Med & Hlth Sci, Div Cardiol,Dept Pediat, Washington, DC USA
[8] Seattle Childrens Hosp, Seattle, WA USA
[9] Univ Toronto, Hosp Sick Children, Toronto, ON, Canada
关键词
HUMAN CORONAVIRUS NL63; CLINICAL-MANIFESTATIONS; ASSOCIATION; INFECTION; DIAGNOSIS; CHILDREN;
D O I
10.1016/j.cjca.2021.05.014
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: The emergence of increasing reports worldwide of a severe inflammatory process and shock in pediatric patients resembling Kawasaki disease (KD)-and, more specifically, Kawasaki disease shock syndrome (KDSS)-prompted us to explore KDSS in a preamble of a systematic comparison between the 2 conditions. Methods: We completed a systematic review of KDSS and performed a meta-analysis comparison between reported KDSS cases and KD controls. Results: A total of 10 case-control series were included in the meta analysis. Patients with KDSS were older (38.4 +/- 30.6 vs 21.9 +/- 19.5 months; P < 0.001) compared with standard KD with equal sex distribution and completeness of clinical diagnostic criteria. KDSS present higher C-reactive protein (59.4 +/- 29.2 mg/dL vs 20.8 +/- 14.8 mg/dL; P < 0.001), lower albumin (2.7 +/- 0.5 g/dL vs 3.3 +/- 0.5 g/dL; P < 0.01), and lower platelets (255 +/- 149 109/L vs 394 +/- 132 109/L; P < 0.001) but only borderline higher white blood cells (P = 0.06). Differences in alanine transaminase, aspartate aminotransferase, and erythrocyte sedimentation rate were nonsignificant. The odds of intravenous immunoglobulin resistance (44.4% vs 9.6%; (P < 0.001) and the hospital length of stay (10.9 +/- 5.8 vs 5.0 +/- 3.0 days; P < 0.001) were higher in KDSS, as were the odds of coronary-artery abnormalities (33.9% vs 8.6%; P < 0.001). Conclusions: This first meta-analysis on KDSS vs KD represents a basis for future works on KDSS and opens the opportunity for future multicentre studies in the search of causal relationships between presenting elements and the eventual complications of KDSS. The similarities between SARS-CoV-2 multisystem inflammatory syndrome in children and KDSS open new horizons to the understanding of the etiology and pathophysiology related to KDSS.
引用
收藏
页码:1619 / 1628
页数:10
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