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Kawasaki-like multisystem inflammatory syndrome in children during the covid-19 pandemic in Paris, France: prospective observational study.
Toubiana, Julie; Poirault, Clément; Corsia, Alice; Bajolle, Fanny; Fourgeaud, Jacques; Angoulvant, François; Debray, Agathe; Basmaci, Romain; Salvador, Elodie; Biscardi, Sandra; Frange, Pierre; Chalumeau, Martin; Casanova, Jean-Laurent; Cohen, Jérémie F; Allali, Slimane.
Afiliación
  • Toubiana J; Department of General Paediatrics and Paediatric Infectious Diseases, Necker-Enfants Malades University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Université de Paris, 149 rue de Sèvres, 75015 Paris, France.
  • Poirault C; Institut Pasteur, Biodiversity and Epidemiology of Bacterial Pathogens, Paris, France.
  • Corsia A; Department of General Paediatrics and Paediatric Infectious Diseases, Necker-Enfants Malades University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Université de Paris, 149 rue de Sèvres, 75015 Paris, France.
  • Bajolle F; Paediatric Intensive Care Unit, Necker-Enfants Malades University Hospital, AP-HP, Université de Paris. Paris, France.
  • Fourgeaud J; M3C-Necker-Enfants Malades University Hospital, Université de Paris, Paris, France.
  • Angoulvant F; Virology Laboratory, Necker-Enfants Malades University Hospital, AP-HP, Université de Paris, Paris, France.
  • Debray A; Pediatric Emergency Department, Necker-Enfants Malades University Hospital, AP-HP; INSERM, Centre de Recherche des Cordeliers, UMRS 1138, Université de Paris, Paris, France.
  • Basmaci R; Department of General Paediatrics and Paediatric Infectious Diseases, Necker-Enfants Malades University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Université de Paris, 149 rue de Sèvres, 75015 Paris, France.
  • Salvador E; Pediatric and Emergency Unit, Louis Mourier Hospital, Université de Paris, Paris, France.
  • Biscardi S; Paediatric Intensive Care Unit, Necker-Enfants Malades University Hospital, AP-HP, Université de Paris. Paris, France.
  • Frange P; Pediatric Emergency Unit, Hôpital Intercommunal, Créteil, France.
  • Chalumeau M; Department of Clinical Microbiology, Necker-Enfants Malades University Hospital, AP-HP; EHU 7328 PACT, Imagine Institute, Université de Paris, Paris, France.
  • Casanova JL; Department of General Paediatrics and Paediatric Infectious Diseases, Necker-Enfants Malades University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Université de Paris, 149 rue de Sèvres, 75015 Paris, France martin.chalumeau@aphp.fr.
  • Cohen JF; Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Centre of Research in Epidemiology and Statistics, INSERM, Université de Paris, Paris, France.
  • Allali S; Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Imagine Institute, Pediatric Hematology and Immunology Unit, Necker-Enfants Malades Hospital, AP-HP, Université de Paris, Paris, France.
BMJ ; 369: m2094, 2020 06 03.
Article en En | MEDLINE | ID: mdl-32493739
OBJECTIVES: To describe the characteristics of children and adolescents affected by an outbreak of Kawasaki-like multisystem inflammatory syndrome and to evaluate a potential temporal association with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. DESIGN: Prospective observational study. SETTING: General paediatric department of a university hospital in Paris, France. PARTICIPANTS: 21 children and adolescents (aged ≤18 years) with features of Kawasaki disease who were admitted to hospital between 27 April and 11 May 2020 and followed up until discharge by 15 May 2020. MAIN OUTCOME MEASURES: The primary outcomes were clinical and biological data, imaging and echocardiographic findings, treatment, and outcomes. Nasopharyngeal swabs were prospectively tested for SARS-CoV-2 using reverse transcription-polymerase chain reaction (RT-PCR) and blood samples were tested for IgG antibodies to the virus. RESULTS: 21 children and adolescents (median age 7.9 (range 3.7-16.6) years) were admitted with features of Kawasaki disease over a 15 day period, with 12 (57%) of African ancestry. 12 (57%) presented with Kawasaki disease shock syndrome and 16 (76%) with myocarditis. 17 (81%) required intensive care support. All 21 patients had noticeable gastrointestinal symptoms during the early stage of illness and high levels of inflammatory markers. 19 (90%) had evidence of recent SARS-CoV-2 infection (positive RT-PCR result in 8/21, positive IgG antibody detection in 19/21). All 21 patients received intravenous immunoglobulin and 10 (48%) also received corticosteroids. The clinical outcome was favourable in all patients. Moderate coronary artery dilations were detected in 5 (24%) of the patients during hospital stay. By 15 May 2020, after 8 (5-17) days of hospital stay, all patients were discharged home. CONCLUSIONS: The ongoing outbreak of Kawasaki-like multisystem inflammatory syndrome among children and adolescents in the Paris area might be related to SARS-CoV-2. In this study an unusually high proportion of the affected children and adolescents had gastrointestinal symptoms, Kawasaki disease shock syndrome, and were of African ancestry.
Asunto(s)

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Neumonía Viral / Infecciones por Coronavirus / Síndrome de Respuesta Inflamatoria Sistémica / Betacoronavirus / Anticuerpos Antivirales Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Adolescent / Child / Child, preschool / Female / Humans / Male País/Región como asunto: Europa Idioma: En Revista: BMJ Asunto de la revista: MEDICINA Año: 2020 Tipo del documento: Article País de afiliación: Francia

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Neumonía Viral / Infecciones por Coronavirus / Síndrome de Respuesta Inflamatoria Sistémica / Betacoronavirus / Anticuerpos Antivirales Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Adolescent / Child / Child, preschool / Female / Humans / Male País/Región como asunto: Europa Idioma: En Revista: BMJ Asunto de la revista: MEDICINA Año: 2020 Tipo del documento: Article País de afiliación: Francia