Evidence map›Paper›PMID 32527868›Full record

ArticleAnnals of the rheumatic diseases2020

Paediatric multisystem inflammatory syndrome temporally associated with SARS-CoV-2 mimicking Kawasaki disease (Kawa-COVID-19): a multicentre cohort.

Marie Pouletty, Charlotte Borocco, Naim Ouldali, Marion Caseris, Romain Basmaci, Noémie Lachaume, Philippe Bensaid, Samia Pichard, Hanane Kouider, Guillaume Morelle and 18 more

Open access · bronzeAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of the rheumatic diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 296 papers, 15 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
296citing papers in PubMed, 15 pooled it
101.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

296 citing papers in PubMed, 15 syntheses or guidelines pooled it, 551 citations in OpenAlex.

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  5. Oral manifestations of multisystemic inflammatory syndrome in children (MIS-C) and Kawasaki disease associated to COVID-19: A systematic review.Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry · 2022
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  7. COVID-19 cutaneous manifestations in children and adolescents: a systematic review.Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo · 2022
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  12. COVID-19 under 19: A meta-analysis.Pediatric pulmonology · 2021
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236 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

28 authors at 8 institutions in 1 country.

Marie PoulettyGeneral Paediatrics, Department of Infectious Disease and Internal Medicine, Reference centre for Rheumatic, AutoImmune and Systemic diseases in children (RAISE), Paris, France, Robert Debré University Hospital, AP-HP, Paris, France.
Charlotte BoroccoDepartment of Pediatric Rheumatology Reference centre for Autoinflammatory diseases and amyloidosis (CEREMAIA), Hôpital Bicêtre, AP-HP, Le Kremlin-Bicêtre, France.
Naim OuldaliGeneral Paediatrics, Department of Infectious Disease and Internal Medicine, Reference centre for Rheumatic, AutoImmune and Systemic diseases in children (RAISE), Paris, France, Robert Debré University Hospital, AP-HP, Paris, France.
Marion CaserisGeneral Paediatrics, Department of Infectious Disease and Internal Medicine, Reference centre for Rheumatic, AutoImmune and Systemic diseases in children (RAISE), Paris, France, Robert Debré University Hospital, AP-HP, Paris, France.
Romain BasmaciDepartments of General Paediatrics and Paediatric Emergency, Louis-Mourier Hospital, AP-HP, Colombes, France.
Noémie LachaumeDepartments of General Paediatrics and Paediatric Emergency, Louis-Mourier Hospital, AP-HP, Colombes, France.
Philippe BensaidDepartment of General Paediatrics, Victor Dupouy Hospital, Argenteuil, France.
Samia PichardDepartment of General Paediatrics, Victor Dupouy Hospital, Argenteuil, France.
Hanane KouiderDepartment of General Paediatrics, René Dubos, Pontoise Hospital, Pontoise, France.
Guillaume MorelleDepartment of General Paediatrics, Hôpital Bicêtre, AP-HP, Le Kremlin-Bicêtre, France.
Irina CraiuPaediatric emergency Department, Hôpital Bicêtre, AP-HP, Le Kremlin-Bicêtre, France.
Corinne PondarreSickle cell disease referal center, INSERM U955, Centre hospitalier Intercommunal de Créteil, Paris XII University, Créteil, France.
Anna DehoPaediatric Intensive Care Unit, Robert Debré University Hospital, AP-HP, Paris, France.
Arielle MaroniPaediatric Intensive Care Unit, Robert Debré University Hospital, AP-HP, Paris, France.
Mehdi OualhaPaediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, AP-HP, Paris, France.
Zahir AmouraInserm UMR-S 1135, Sorbonne Université, Paris, France.
Julien HarocheInserm UMR-S 1135, Sorbonne Université, Paris, France.
Juliette ChommelouxMedical Intensive Care Unit, Institut de Cardiologie, AP-HP, Sorbonne University, Pitié-Salpêtrière Hospital, Paris, France.
Fanny BajolleCardiopaediatric Unit, M3-C, Necker-Enfants-Malades University Hospital, AP-HP, Paris, France.
Constance BeylerCardiopaediatric Unit, Robert Debré University Hospital, AP-HP, Paris, France.
Stéphane BonacorsiDepartment of Microbiology, Robert Debré University Hospital,AP-HP, Paris, France.
Guislaine CarcelainDepartment of Immunology, Robert Debré University Hospital, AP-HP, Paris, France.
Isabelle Koné-PautDepartment of Pediatric Rheumatology Reference centre for Autoinflammatory diseases and amyloidosis (CEREMAIA), Hôpital Bicêtre, AP-HP, Le Kremlin-Bicêtre, France.ORCID 0000-0001-8939-5763
Brigitte Bader-MeunierPaediatric Hematology-Immunology and Rheumatology Department, Reference centre for Rheumatic, AutoImmune and Systemic diseases in children (RAISE), Paris, France, Necker-Enfants-Malades University Hospital, AP-HP, Paris, France.ORCID 0000-0001-8476-8196
Albert FayeGeneral Paediatrics, Department of Infectious Disease and Internal Medicine, Reference centre for Rheumatic, AutoImmune and Systemic diseases in children (RAISE), Paris, France, Robert Debré University Hospital, AP-HP, Paris, France.
Ulrich MeinzerGeneral Paediatrics, Department of Infectious Disease and Internal Medicine, Reference centre for Rheumatic, AutoImmune and Systemic diseases in children (RAISE), Paris, France, Robert Debré University Hospital, AP-HP, Paris, France.
Caroline GaleottiDepartment of Pediatric Rheumatology Reference centre for Autoinflammatory diseases and amyloidosis (CEREMAIA), Hôpital Bicêtre, AP-HP, Le Kremlin-Bicêtre, France.
Isabelle MelkiGeneral Paediatrics, Department of Infectious Disease and Internal Medicine, Reference centre for Rheumatic, AutoImmune and Systemic diseases in children (RAISE), Paris, France, Robert Debré University Hospital, AP-HP, Paris, France isabelle.melki@aphp.fr.ORCID 0000-0002-8057-333X
Inserm · FRAssistance Publique – Hôpitaux de Paris · FRHôpital Necker-Enfants Malades · FRCentre Hospitalier Victor Dupouy · FRUniversité Paris-Sud · FRCentre Hospitalier René-Dubos · FRSorbonne Université · FRUniversité Paris Cité · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCurrent data suggest that COVID-19 is less frequent in children, with a milder course. However, over the past weeks, an increase in the number of children presenting to hospitals in the greater Paris region with a phenotype resembling Kawasaki disease (KD) has led to an alert by the French national health authorities.

methodsMulticentre compilation of patients with KD in Paris region since April 2020, associated with the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ('Kawa-COVID-19'). A historical cohort of 'classical' KD served as a comparator.

resultsSixteen patients were included (sex ratio=1, median age 10 years IQR (4·7 to 12.5)). SARS-CoV-2 was detected in 12 cases (69%), while a further three cases had documented recent contact with a quantitative PCR-positive individual (19%). Cardiac involvement included myocarditis in 44% (n=7). Factors prognostic for the development of severe disease (ie, requiring intensive care, n=7) were age over 5 years and ferritinaemia >1400 µg/L. Only five patients (31%) were successfully treated with a single intravenous immunoglobulin (IVIg) infusion, while 10 patients (62%) required a second line of treatment. The Kawa-COVID-19 cohort differed from a comparator group of 'classical' KD by older age at onset 10 vs 2 years (p<0.0001), lower platelet count (188 vs 383 G/L (p<0.0001)), a higher rate of myocarditis 7/16 vs 3/220 (p=0.0001) and resistance to first IVIg treatment 10/16 vs 45/220 (p=0.004).

conclusionKawa-COVID-19 likely represents a new systemic inflammatory syndrome temporally associated with SARS-CoV-2 infection in children. Further prospective international studies are necessary to confirm these findings and better understand the pathophysiology of Kawa-COVID-19.

Indexed as

BetacoronavirusAdolescentChildChild, PreschoolCohort StudiesCoronavirus InfectionsCOVID-19Diagnosis, DifferentialFemaleHumansMaleMucocutaneous Lymph Node SyndromePandemicsParisPneumonia, ViralSARS-CoV-2cytokinesinflammationoutcome and process assessment, health care

Identifiers

PMID32527868
PMCPMC7299653
OpenAlexW3034537415

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.