The Association between Kawasaki Disease and COVID-19: The Alarm for Pediatrics

Abstract

Context: In 2019, a novel Coronavirus officially named by WHO as coronavirus disease of 2019 (COVID-19) pneumonia quickly spread worldwide and became a pandemic. At first, it was considered that the complications just included older populations, but its association with Kawasaki vasculitis disease further complicated the issues. Evidence Acquisition: A literature search was conducted using various scientific databases of Springer, Scopus, Wiley, Science Direct, PubMed, ProQuest, Cochrane Library, Embase, and Clinical Key. Keywords COVID-19, Kawasaki vasculitis, Mucocutaneous Lymph Node Syndrome, pediatric, RNA viruses, cytokine storm, 2019 nCoV Diseases, SARS CoV 2 Infection, and SARS CoV 2 were used to filter the search results. After assessing each retrieved article against inclusion-exclusion criteria, 63 papers were deemed eligible for inclusion in this review. Results: Our study linked Kawasaki disease with COVID-19 pneumonia in three pathways: (1) Interference of angiotensin-converting enzyme 2 (ACE2) receptor and renin-angiotensin-aldosterone system (RAAS) in the pathogenesis of SARS CoV 2 and Kawasaki vasculitis diseases, (2) The similarity of clinical manifestation and immune system response in SARS CoV 2 and Kawasaki vasculitis diseases, (3) The role of COVID-19 as a risk factor next to other risk factors. Conclusions: Kawasaki vasculitis disease could be indicated along with infection with Coronaviridae viruses in pediatrics. Recognition of Kawasaki vasculitis disease with focusing on COVID-19 pathogenesis, aside from restriction of risk factors and detection of best treatment.