TABLE 4B.
Patients from CoV- cohort indicating complete/incomplete KD and the criteria met for PIMS-TS and MIS-C diagnosis.
| Patient number | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 | 16 | 17 | 18 | 19 | 20 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Complete/Incomplete KD | I | I | C | C | I | I | C | * | I | I | I | I | C | I | C | I | C | I | C | C |
| Fever > 3 d | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x |
| Rash/ Conjunctivitis/Mucocutaneous inflammation signs | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x | |
| Hypotension/Shock | x | x | x | x | ||||||||||||||||
| Myocardial dysfunction/pericarditis/valvulitis/ CAA | x | x | x | x | x | x | x | x | x | x | x | |||||||||
| Coagulopathy | x | x | x | x | ||||||||||||||||
| GI symptoms | x | x | x | x | x | x | x | x | x | x | x | |||||||||
| PCR> 5 mg/dL | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x | |||
| PCT > 1 ng/mL | x | x | x | x | x | |||||||||||||||
| No other cause | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x |
| MIS-C (WHO) | Yes | Yes | No | No | No | No | No | Yes | No | No | No | No | Yes | No | Yes | Yes | Yes | Yes | No | No |
| Persistent fever | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x |
| Persistent inflammation | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x |
| Single or multi-organ dysfunction | x | x | x | x | x | x | x | x | x | x | ‡ | |||||||||
| Shock | x | x | x | x | ||||||||||||||||
| Cardiac disorder | x | x | x | x | x | x | x | x | ||||||||||||
| Respiratory disorder | x | x | ||||||||||||||||||
| Renal disorder | ||||||||||||||||||||
| GI disorder | x | x | x | # | # | x | x | x | x | ‡ | ||||||||||
| Neurological disorder | ||||||||||||||||||||
| No other cause | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x | x | |
| SARS-CoV-2 | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - |
| PIMS-TS (RCPCH) | Yes | Yes | No | No | Yes | No | No | No | Yes | No | Yes | No | Yes | No | Yes | Yes | No | Yes | No | No |
BP, Blood pressure; C, Complete; CAA, Coronary artery abnormalities; GI, Gastrointestinal; I, Incomplete; KD, Kawasaki disease; MIS-C, Multisystem inflammatory syndrome in children; PIMS-TS, Pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2; RCPCH, Royal College of Paediatrics and Child Health; WHO, World Health Organization.
These patients didn't meet the criteria for KD at the moment of admission, but they fulfilled the criteria for incomplete KD during admission.
These patients complained only of abdominal pain.
These patients had elevation of liver enzymes but <2 upper limit of normality.
Diagnostic criteria of inflammatory:
•MIS-C (WHO):
° Children and adolescents 0–19 years of age with fever > 3 days AND two of the following:
a) Rash or bilateral non-purulent conjunctivitis or mucocutaneous inflammation signs (oral, hands, or feet).
b) Hypotension or shock.
c) Features of myocardial dysfunction, pericarditis, valvulitis, or coronary abnormalities (including ECHO findings or elevated troponin/NT-proBNP)
d) Evidence of coagulopathy (by PT, PTT, elevated D-Dimers).
e) Acute gastrointestinal problems (diarrhea, vomiting, or abdominal pain).
° AND elevated markers of inflammation such as ESR, C-reactive protein, or procalcitonin.
° AND no other obvious microbial cause of inflammation, including bacterial sepsis, staphylococcal or streptococcal shock síndrome.
° AND evidence of COVID-19 (RT-PCR, antigen test, or serology positive), or likely contact with patients with COVID-19.
• PIMS-TS (RCPCH):
° A child presenting with persistent fever, inflammation (neutrophilia, elevated CRP and lymphopaenia) and evidence of single or multi-organ dysfunction (shock, cardiac, respiratory, renal, gastrointestinal or neurological disorder) with other additional clinical, laboratory or imagining and ECG features. Children fulfilling full or partial criteria for Kawasaki disease may be included.
° Exclusion of any other microbial cause, including bacterial sepsis, staphylococcal or streptococcal shock syndromes, infections associated with myocarditis such as enterovirus.
° SARS-CoV-2 PCR testing positive or negative.