Table 1.

Differences of multiple inflammatory syndrome in children associated with COVID-19 and Kawasaki disease

Items	MIS-C	KD
Age	Median age: 6–10 years	76% cases < 5 years
Sex	More common in male	Male: female about 1.5:1
Ethnic distribution	High proportion of African ethnicity or ancestry, as well as Hispanic subjects	Asian children have the highest incidence in the world
Clinical features
Fever	100%	100%
Rash	50–75%	Above 90%
Mucous membrane involvement	60–94%	Above 90%
Conjunctivitis	48–69%	Above 90%
Hands and feet erythema/edema	26–68%	About 75%
Cervical lymphadenopathy	30–70%	50–70%
Classic and incomplete KD presentation	25–65.5%	100%
Shock (KDSS)	33–87%	2–7%
MAS	3–50%	1.1–1.9%
Other clinical features
Gastrointestinal symptoms	60–100%	Rare
Respiratory distress	12–46%	Rare
Cardiac manifestation	18–87%	Rare
CAA	14–36%	4%
Laboratory features
Lymphopenia	37–81%	Rare
Platelets	Decreased	Increased
Level of inflammatory markers	Noticeably increased	Increased
Troponin T	More common	Rare
BNP	Marked increased	Mild increased
Ferritin	Highly elevated	Normal
D-dimer	Significantly increase	Normal
SARS-Cov2 positive (serology or PCR)	80–100%	None
Treatment
Intropes/vasopressors	25–100%	Rare
Mechanical ventilation	13–57%	Rare
Aspirin	3–28%	Very rare
ECMO	In some cases (0%-75%)	100%
IVIG	54–100%	100%
Steroid	20–83%	In some cases
Biologic drugs	7–80%	Occasionally reported
Outcomes
Mortality	About 2.1–18%	About 0.17%

MIS-C multiple inflammatory syndrome in children, MAS macrophagic activation syndrome, CAA coronary artery aneurysm, IVIG intravenous immunoglobulin, KD Kawasaki disease, PCR polymerase chain reaction, ECMO extracorporeal membrane oxygenation, KDSS Kawasaki disease shock syndrome, BNP brain natriuretic peptide