Table 1.
Clinical and laboratory features of ten patients with Kawasaki-like disease who presented over 1 month during SARS-CoV-2 epidemic (group 2)
| Patient 1 | Patient 2 | Patient 3 | Patient 4 | Patient 5 | Patient 6 | Patient 7 | Patient 8 | Patient 9 | Patient 10 | ||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Date of onset | March 17, 2020 | March 27, 2020 | March 28, 2020 | April 3, 2020 | April 3, 2020 | April 4, 2020 | April 6, 2020 | April 10, 2020 | April 11, 2020 | April 14, 2020 | |
| Age, years | 8·2 | 7·0 | 2·9 | 7·7 | 7·5 | 16·0 | 5·0 | 9·2 | 5·5 | 5·5 | |
| Sex | Male | Male | Female | Female | Female | Male | Male | Male | Male | Male | |
| Type of Kawasaki disease | Incomplete | Incomplete | Classic | Incomplete | Incomplete | Classic | Classic | Incomplete | Classic | Classic | |
| Other symptom | .. | Diarrhoea, meningeal signs | .. | Diarrhoea, meningeal signs | Diarrhoea | Diarrhoea | Meningeal signs | Diarrhoea | Meningeal signs | Diarrhoea, drowsiness | |
| ESR, mm/h | .. | 60 | 39 | 108 | 97 | .. | 51 | 84 | 81 | 54 | |
| Lymphocytes, × 109 per L | 803 | 1060 | 970 | 930 | 450 | 790 | 1870 | 860 | 420 | 460 | |
| Blood culture | .. | Sterile | Sterile | Sterile | Sterile | Sterile | Sterile | Sterile | Sterile | Sterile | |
| Chest x-ray | Pneumonia | Pneumonia | Pneumonia | Normal | Normal | Normal | Normal | Pneumonia | Normal | Pneumonia | |
| Echocardiography | Abnormal | Normal | Normal | Abnormal | Abnormal | Abnormal | Normal | Abnormal | Normal | Abnormal | |
| Aneurism | >4 mm | No | No | No | No | No | No | >4 mm | No | No | |
| Ejection fraction | 48% | >55% | >55% | 25% | 30% | >55% | >55% | 40% | >55% | 45% | |
| Mitral valve regurgitation | Yes | No | No | Yes | Yes | No | No | Yes | No | No | |
| Pericardial effusion | Yes | No | No | Yes | Yes | Yes | No | No | No | No | |
| Kobayashi ≥5 | Yes (6) | Yes (6) | No (4) | Yes (6) | Yes (6) | No (3) | No (2) | Yes (6) | Yes (6) | Yes (6) | |
| <12 months | No | No | No | No | No | No | No | No | No | No | |
| Kawasaki disease signs at day 4 | No | No | No | No | No | No | No | No | No | No | |
| CRP ≥10 mg/dL | Yes (0·9) | Yes (31·1) | Yes (15·2) | Yes (48·0) | Yes (52·5) | No (7·3) | Yes (24·0) | Yes (24·2) | Yes (24·6) | Yes (12·2) | |
| Neutrophils ≥80% | Yes (80·0) | Yes (89·7) | No (77·3) | Yes (90·0) | Yes (90·5) | No (79·4) | No (77·9) | Yes (91·9) | Yes (85·5) | Yes (83·0) | |
| Platelets ≤300 × 109 per L | Yes (119) | Yes (121) | Yes (66) | Yes (142) | Yes (113) | Yes (121) | Yes (138) | Yes (192) | Yes (151) | Yes (142) | |
| Sodium ≤133 mEq/L | Yes (131) | Yes (130) | Yes (132) | Yes (128) | Yes (129) | No (135) | No (135) | Yes (133) | Yes (133) | Yes (122) | |
| ALT ≥100 U/L | No (32) | No (79) | No (46) | No (82) | No (78) | Yes (733) | No (41) | No (63) | No (20) | No (20) | |
| MAS18 | .. | Yes | Yes | Yes | Yes | Yes | No | No | No | No | |
| Ferritin >684 ng/mL | .. | Yes (1183) | Yes (893) | Yes (1972) | Yes (3213) | Yes (2027) | No (199) | No (449) | No (307) | No (341) | |
| Platelets ≤181 × 109 per L | Yes (119) | Yes (121) | Yes (66) | Yes (142) | Yes (113) | Yes (121) | Yes (138) | No (192) | Yes (151) | Yes (142) | |
| AST >48 IU/L | No (30) | Yes (120) | Yes (63) | Yes (174) | Yes (89) | Yes (237) | Yes (50) | Yes (51) | No (29) | No (30) | |
| Triglycerides ≥156 mg/dL | − | Yes (434) | Yes (367) | Yes (263) | Yes (198) | .. | Yes (161) | Yes (200) | Yes (171) | No (121) | |
| Fibrinogen ≤360 mg/dL | No (465) | No (599) | No (506) | No (924) | No (759) | Yes (313) | No (637) | No (759) | No (759) | No (489) | |
| KDSS14 | No | No | No | Yes | Yes | Yes | No | Yes | No | Yes | |
| Hypotension | No | No | No | Yes | Yes | Yes | No | Yes | No | Yes | |
| SBP ≤20% basal | No | No | No | No | No | No | No | No | No | No | |
| Peripheral hypoperfusion | No | No | No | Yes | Yes | No | No | Yes | No | Yes | |
| CPK, nv 461–71 IU/L | 16 | 84 | 76 | 247 | 89 | 119 | 79 | 40 | 59 | 40 | |
| Troponin I, nv ≤53 ng/L | 111 | 188 | − | 200 | 3557 | 4906 | 12 | 36 | <3 | 23 | |
| proBNP, nv 1–00 ng/L | 1870 | 952 | 1519 | 2072 | 1665 | 108 | 347 | 2957 | 139 | 927 | |
| Nasal swab for respiratory pathogens | Negative | Negative | Negative | Negative | Negative | Negative | Negative | Negative | Negative | Negative | |
| Nasal swab for SARS-CoV-2 | Negative | Positive | Negative | Negative | Positive | Negative | Negative | Negative | Negative | Negative | |
| Serology for SARS-CoV-2 (IgG, IgM) | Negative, negative | Positive, negative | Positive, negative | Positive, positive | Positive, positive | Negative, negative* | Positive, negative | Positive, negative | Positive, positive | Positive, negative | |
| Serology (days from onset) | 30 | 18 | 16 | 11 | 11 | 10 | 8 | 7 | 4 | 6 | |
| Contact with suspected or confirmed case | No | Yes | No | No | Yes | No | Yes | No | Yes | Yes | |
| Caregiver nasal swab for SARS-CoV-2 | .. | Positive | Negative | Negative | Negative | Negative | Positive | Negative | Negative | Positive | |
| Treatment | IVIG plus aspirin | IVIG plus mPDN | IVIG plus mPDN | IVIG plus mPDN | IVIG plus mPDN | IVIG plus mPDN | IVIG plus aspirin | IVIG plus mPDN | IVIG plus mPDN | IVIG plus mPDN | |
| Inotropes | No | No | No | Yes | Yes | No | No | No | No | No | |
| Response | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | |
ESR=erythrocyte sedimentation rate. CRP=C-reactive protein. MAS=Macrophage Activation Syndrome. ALT=alanine aminotransferase. AST=aspartate aminotransferase. KDSS=Kawasaki disease shock syndrome. SBP=systolic blood pressure. CPK=creatine phosphokinase. BNP=B-type natriuretic peptide. nv=normal values. SARS-CoV-2=severe acute respiratory syndrome coronavirus 2. IVIG=intravenous immunoglobulin. mPDN=methylprednisolone.
*
Test done shortly after high-dose IVIG.