Evidence map›Paper›PMID 32622376›Full record

ArticleThe Lancet. Child & adolescent health2020

Emergence of Kawasaki disease related to SARS-CoV-2 infection in an epicentre of the French COVID-19 epidemic: a time-series analysis.

Naim Ouldali, Marie Pouletty, Patricia Mariani, Constance Beyler, Audrey Blachier, Stephane Bonacorsi, Kostas Danis, Maryline Chomton, Laure Maurice, Fleur Le Bourgeois and 8 more

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

Article in The Lancet. Child & adolescent health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 97 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
97citing papers in PubMed, 4 pooled it
32.5field-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

97 citing papers in PubMed, 4 syntheses or guidelines pooled it, 183 citations in OpenAlex.

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  4. Kawasaki-like disease in children with COVID-19.Rheumatology international · 2020
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37 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors at 8 institutions in 1 country.

Naim OuldaliDepartment of General Paediatrics, Paediatric Internal Medicine, Rheumatology and Infectious Diseases, National Referee Centre for Rheumatic, Autoimmune and Systemic Diseases in Children, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Université de Paris, INSERM UMR 1123, ECEVE, Paris, France; Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; Université de Paris, UFR de Médecine Paris Nord, Paris, France.
Marie PoulettyDepartment of General Paediatrics, Paediatric Internal Medicine, Rheumatology and Infectious Diseases, National Referee Centre for Rheumatic, Autoimmune and Systemic Diseases in Children, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Université de Paris, UFR de Médecine Paris Nord, Paris, France.
Patricia MarianiUniversité de Paris, UFR de Médecine Paris Nord, Paris, France; Department of Microbiology, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Constance BeylerDepartment of Pediatric Cardiology, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Audrey BlachierDepartment of Medical Information, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Stephane BonacorsiUniversité de Paris, UFR de Médecine Paris Nord, Paris, France; Department of Microbiology, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Université de Paris, IAME, INSERM UMR1137, Paris, France.
Kostas DanisSanté Publique France, Saint Maurice, France.
Maryline ChomtonPaediatric Intensive Care Unit, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Laure MauricePaediatric Intensive Care Unit, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Fleur Le BourgeoisPaediatric Intensive Care Unit, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Marion CaserisDepartment of General Paediatrics, Paediatric Internal Medicine, Rheumatology and Infectious Diseases, National Referee Centre for Rheumatic, Autoimmune and Systemic Diseases in Children, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Department of Microbiology, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Jean GaschignardDepartment of General Paediatrics, Paediatric Internal Medicine, Rheumatology and Infectious Diseases, National Referee Centre for Rheumatic, Autoimmune and Systemic Diseases in Children, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Université de Paris, UFR de Médecine Paris Nord, Paris, France; Université de Paris, IAME, INSERM UMR1137, Paris, France.
Julie PolineDepartment of General Paediatrics, Paediatric Internal Medicine, Rheumatology and Infectious Diseases, National Referee Centre for Rheumatic, Autoimmune and Systemic Diseases in Children, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Center for Research on Inflammation, INSERM, UMR1149, Paris, France.
Robert CohenUniversité de Paris, UFR de Médecine Paris Nord, Paris, France.
Luigi TitomanlioUniversité de Paris, UFR de Médecine Paris Nord, Paris, France; Department of Paediatric Emergency Care, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Albert FayeDepartment of General Paediatrics, Paediatric Internal Medicine, Rheumatology and Infectious Diseases, National Referee Centre for Rheumatic, Autoimmune and Systemic Diseases in Children, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Université de Paris, INSERM UMR 1123, ECEVE, Paris, France; Université de Paris, UFR de Médecine Paris Nord, Paris, France.
Isabelle MelkiDepartment of General Paediatrics, Paediatric Internal Medicine, Rheumatology and Infectious Diseases, National Referee Centre for Rheumatic, Autoimmune and Systemic Diseases in Children, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Laboratory of Neurogenetics and Neuroinflammation, Imagine Institute, Paris, France; Paediatric Haematology-Immunology and Rheumatology Department, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, National Referee Centre for Rheumatic, Autoimmune and Systemic Diseases in Children, Paris, France.
Ulrich MeinzerDepartment of General Paediatrics, Paediatric Internal Medicine, Rheumatology and Infectious Diseases, National Referee Centre for Rheumatic, Autoimmune and Systemic Diseases in Children, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Université de Paris, UFR de Médecine Paris Nord, Paris, France; Center for Research on Inflammation, INSERM, UMR1149, Paris, France; Biology and Genetics of Bacterial Cell Wall Unit, Pasteur Institute, Paris, France. Electronic address: ulrich.meinzer@aphp.fr.
Hôpital Robert-Debré · FRAssistance Publique – Hôpitaux de Paris · FRÉpidémiologie Clinique, Évaluation Économique Appliquées aux Populations Vulnérables · FRInfection, Anti-microbiens, Modélisation, EvolutionInstitut des Maladies Génétiques Imagine · FRSanté Publique France · FRSorbonne Paris Cité · FRUniversité Paris Cité · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundKawasaki disease is an acute febrile systemic childhood vasculitis, which is suspected to be triggered by respiratory viral infections. We aimed to examine whether the ongoing COVID-19 epidemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is associated with an increase in the incidence of Kawasaki disease.

methodsWe did a quasi-experimental interrupted time series analysis over the past 15 years in a tertiary paediatric centre in the Paris region, a French epicentre of the COVID-19 outbreak. The main outcome was the number of Kawasaki disease cases over time, estimated by quasi-Poisson regression. In the same centre, we recorded the number of hospital admissions from the emergency department (2005-2020) and the results of nasopharyngeal multiplex PCR to identify respiratory pathogens (2017-2020). These data were compared with daily hospital admissions due to confirmed COVID-19 in the same region, recorded by Public Health France.

findingsBetween Dec 1, 2005, and May 20, 2020, we included 230 patients with Kawasaki disease. The median number of Kawasaki disease hospitalisations estimated by the quasi-Poisson model was 1·2 per month (IQR 1·1-1·3). In April, 2020, we identified a rapid increase of Kawasaki disease that was related to SARS-CoV-2 (six cases per month; 497% increase [95% CI 72-1082]; p=0·0011), starting 2 weeks after the peak of the COVID-19 epidemic. SARS-CoV-2 was the only virus circulating intensely during this period, and was found in eight (80%) of ten patients with Kawasaki disease since April 15 (SARS-CoV-2-positive PCR or serology). A second peak of hospital admissions due to Kawasaki disease was observed in December, 2009 (six cases per month; 365% increase ([31-719]; p=0.0053), concomitant with the influenza A H1N1 pandemic.

interpretationOur study further suggests that viral respiratory infections, including SAR-CoV-2, could be triggers for Kawasaki disease and indicates the potential timing of an increase in incidence of the disease in COVID-19 epidemics. Health-care providers should be prepared to manage an influx of patients with severe Kawasaki disease, particularly in countries where the peak of COVID-19 has recently been reached.

fundingFrench National Research Agency.

Indexed as

BetacoronavirusForecastingPandemicsAdolescentChildChild, PreschoolCoronavirus InfectionsCOVID-19FemaleFollow-Up StudiesFranceHumansIncidenceInfantInfant, NewbornMale

Identifiers

PMID32622376
PMCPMC7332278
OpenAlexW3040393616

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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.