(P047) KAWASAKI DISEASE, MULTISYSTEM INFLAMMATORY SYNDROME IN CHILDREN AND COVID-19 IN A TERTIARY PEDIATRIC HOSPITAL IN MONTREAL, CANADA

Background: During the SARS-CoV-2 (COVID-19) pandemic speculation arose on possible association between Kawasaki Disease (KD), Multisystem Inflammatory Syndrome in Children (MIS-C) and COVID-19. This retrospective study describes the demographics and clinical course of children diagnosed with KD or MIS-C during COVID-19 pandemic.

METHODS AND RESULTS:

Methods: Retrospective chart reviews on children hospitalized at CHU Sainte Justine in Montreal, Canada, for KD (n=46) or MIS-C (n=73) between 01/2020 and 02/2022.

Results: Only 13.4% KD patients tested rt-PCR positive for COVID-19 or were exposed to a positive contact before symptom onset vs. 82.19% MIS-C patients. KD patients were 3.61±3.56 years old vs. MIS-C 8.38±4.17 years (p < 0.0001); 52.17% vs. 63.01% male. No KD case required pediatric intensive care unit (PICU) admission vs. 52% MIS-C (p < 0.0001) with an average PICU duration of 3.18±2.08 days. Ethnic origins in KD vs. MIS-C respectively included African (6.52% vs.15.07%), Arab (13.04% vs. 27.40%), Asian (2.17% vs. 2.74%), Caribbean (2.17% vs. 5.48%), Hispanic (2.17% vs. 4.11%), Caucasian (56.52% vs. 35.62%), and mixed-ethnicity (17.39% vs. 4.11%); with a 2.2±0.5 average odds ratio for non-Caucasians to develop MIS-C/KD (p < 0.01). Most common KD clinical criteria observed with MIS-C were (table) conjunctivitis and skin rash with a Median of 4[1-5] criteria in KD vs. 2[0-5] criteria in MIS-C. Fever duration was 8.20±3.50 days for KD vs. 8.15±3.65 for MIS-C (p=0.94) and hospital duration 5.09±2.32 days in KD vs. 7.66±3.52 in MIS-C (p < 0.0001). Coronary dilatations with a Z-score of greater than or equal to 3.0 occurred in 21.74% of KD patients vs. 9.59% of MIS-C patients (p=0.10).

Conclusion: Demographics and clinical course of patients with KD and MIS-C during the SARS-CoV-2 pandemic suggest that MIS-C affects less Caucasians and children with mixed origins (vs. KD), to the detriment to those of African, Arab, Caribbean, and Hispanic descent. However, MIS-C patients were older and tested COVID-19 positive or were exposed to a COVID positive contact in a much higher proportion compared to KD. A trend towards less coronary complications associated with MIS-C did not reach statistical significance though.