TY - JOUR T1 - Paediatric multisystem inflammatory syndrome temporally associated with SARS-CoV-2 mimicking Kawasaki disease (Kawa-COVID-19): a multicentre cohort JF - Annals of the Rheumatic Diseases JO - Ann Rheum Dis SP - 999 LP - 1006 DO - 10.1136/annrheumdis-2020-217960 VL - 79 IS - 8 AU - Marie Pouletty AU - Charlotte Borocco AU - Naim Ouldali AU - Marion Caseris AU - Romain Basmaci AU - Noémie Lachaume AU - Philippe Bensaid AU - Samia Pichard AU - Hanane Kouider AU - Guillaume Morelle AU - Irina Craiu AU - Corinne Pondarre AU - Anna Deho AU - Arielle Maroni AU - Mehdi Oualha AU - Zahir Amoura AU - Julien Haroche AU - Juliette Chommeloux AU - Fanny Bajolle AU - Constance Beyler AU - Stéphane Bonacorsi AU - Guislaine Carcelain AU - Isabelle Koné-Paut AU - Brigitte Bader-Meunier AU - Albert Faye AU - Ulrich Meinzer AU - Caroline Galeotti AU - Isabelle Melki Y1 - 2020/08/01 UR - http://ard.bmj.com/content/79/8/999.abstract N2 - Background Current 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.Methods Multicentre 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.Results Sixteen 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).Conclusion Kawa-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. Trial registration number NCT02377245 ER -