Table.

Distinct features of Kawasaki disease and coronavirus infections

Kawasaki diseases	Coronavirus infections
No virus can be isolated from cultures of clinical specimens17,18	Virus can be isolated from cultures of clinical specimens
No coronavirus is identified by high throughput RNA sequencing of tissues from patients with Kawasaki disease19, 20, 21	Virus can be identified by high-throughput RNA sequencing of tissues from infected patients
No signal exists for serologic cross-reactivity with coronaviruses, even using new highly sensitive VirScan method17,18,20	Serologic cross reactivity occurs with other coronaviruses, particularly those in the same subfamily22
Recurrence is rare; disease is rare in adolescents and adults	Immunity wanes and infections with most coronaviruses generally recur lifelong23
Numerous reverse transcriptase polymerase chain reaction studies investigating coronavirus as potential cause have been negative	Viral RNA is consistently detected in patient samples by reverse transcriptase polymerase chain reaction
Inclusion bodies have been identified in ciliated bronchial epithelium that are targeted by antibodies from patients with Kawasaki disease19; virus-like particles found adjacent to inclusion bodies are about 50 nm in diameter24	No inclusion bodies are identifiable in bronchial epithelium; virus particles are ∼120 nm in diameter
Patients have an antigen-driven immune response that is not directed at coronavirus19	Immune response is directed at coronavirus
Coronary artery aneurysms occur; thrombosis is limited to within aneurysms	Hypercoagulability with vascular thrombosis at multiple sites is characteristic of SARS-CoV-2 infection; coronary artery aneurysms are not reported in acute SARS-CoV-2 infection; autopsy in the only pediatric patient reported to date with cardiac death from SARS-CoV-2 showed eosinophilic myocarditis with no evidence of vascular inflammation25
Epidemiologic and histologic evidence supports the hypothesis of persistent infection26,27	There is no persistent infection
The median age of patients with Kawasaki disease-associated shock is 2.8 years28	The median age of patients with SARS-CoV-2 associated pediatric shock is 9-10 years1,9