PMID- 34090979
OWN - NLM
STAT- MEDLINE
DCOM- 20211206
LR  - 20230103
IS  - 1916-7075 (Electronic)
IS  - 0828-282X (Print)
IS  - 0828-282X (Linking)
VI  - 37
IP  - 10
DP  - 2021 Oct
TI  - Kawasaki Disease Shock Syndrome vs Classical Kawasaki Disease: A Meta-analysis 
      and Comparison With SARS-CoV-2 Multisystem Inflammatory Syndrome.
PG  - 1619-1628
LID - S0828-282X(21)00290-7 [pii]
LID - 10.1016/j.cjca.2021.05.014 [doi]
AB  - BACKGROUND: The emergence of increasing reports worldwide of a severe 
      inflammatory process and shock in pediatric patients resembling Kawasaki disease 
      (KD)-and, more specifically, Kawasaki disease shock syndrome (KDSS)-prompted us 
      to explore KDSS in a preamble of a systematic comparison between the 2 
      conditions. METHODS: We completed a systematic review of KDSS and performed a 
      meta-analysis comparison between reported KDSS cases and KD controls. RESULTS: A 
      total of 10 case-control series were included in the meta-analysis. Patients with 
      KDSS were older (38.4 +/- 30.6 vs 21.9 +/- 19.5 months; P < 0.001) compared with 
      standard KD with equal sex distribution and completeness of clinical diagnostic 
      criteria. KDSS present higher C-reactive protein (59.4 +/- 29.2 mg/dL vs 20.8 +/- 
      14.8 mg/dL; P < 0.001), lower albumin (2.7 +/- 0.5 g/dL vs 3.3 +/- 0.5 g/dL; P < 
      0.01), and lower platelets (255 +/- 149 109/L vs 394 +/- 132 109/L; P < 0.001) but 
      only borderline higher white blood cells (P = 0.06). Differences in alanine 
      transaminase, aspartate aminotransferase, and erythrocyte sedimentation rate were 
      nonsignificant. The odds of intravenous immunoglobulin resistance (44.4% vs 9.6%; 
      (P < 0.001) and the hospital length of stay (10.9 +/- 5.8 vs 5.0 +/- 3.0 days; P < 
      0.001) were higher in KDSS, as were the odds of coronary-artery abnormalities 
      (33.9% vs 8.6%; P < 0.001). CONCLUSIONS: This first meta-analysis on KDSS vs KD 
      represents a basis for future works on KDSS and opens the opportunity for future 
      multicentre studies in the search of causal relationships between presenting 
      elements and the eventual complications of KDSS. The similarities between 
      SARS-CoV-2 multisystem inflammatory syndrome in children and KDSS open new 
      horizons to the understanding of the etiology and pathophysiology related to 
      KDSS.
CI  - Copyright (c) 2021 Canadian Cardiovascular Society. Published by Elsevier Inc. All 
      rights reserved.
FAU - Lamrani, Loubna
AU  - Lamrani L
AD  - Division of Pediatric Cardiology, CHU Ste-Justine, Universite de Montreal, 
      Montreal, Quebec, Canada; McGill University, School of Medicine, Montreal, 
      Quebec, Canada.
FAU - Manlhiot, Cedric
AU  - Manlhiot C
AD  - Department of Pediatrics, Johns Hopkins University, Baltimore, Maryland, USA.
FAU - Elias, Matthew D
AU  - Elias MD
AD  - Division of Cardiology, The Children's Hospital of Philadelphia, Philadelphia, 
      Pennsylvania, USA.
FAU - Choueiter, Nadine F
AU  - Choueiter NF
AD  - Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, 
      New York, USA.
FAU - Dionne, Audrey
AU  - Dionne A
AD  - Department of Cardiology, Boston Children's Hospital, Department of Pediatrics, 
      Harvard Medical School, Boston, Massachusetts, USA.
FAU - Harahsheh, Ashraf S
AU  - Harahsheh AS
AD  - Division of Cardiology, Children's National Hospital, Department of Pediatrics, 
      George Washington University School of Medicine & Health Sciences, Washington, 
      DC, USA.
FAU - Portman, Michael A
AU  - Portman MA
AD  - Seattle Children's Hospital, Seattle, Washington, USA.
FAU - McCrindle, Brian W
AU  - McCrindle BW
AD  - Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
FAU - Dahdah, Nagib
AU  - Dahdah N
AD  - Division of Pediatric Cardiology, CHU Ste-Justine, Universite de Montreal, 
      Montreal, Quebec, Canada. Electronic address: nagib.dahdah.hsj@ssss.gouv.qc.ca.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20210606
PL  - England
TA  - Can J Cardiol
JT  - The Canadian journal of cardiology
JID - 8510280
RN  - pediatric multisystem inflammatory disease, COVID-19 related
SB  - IM
MH  - COVID-19/blood/*complications/diagnosis
MH  - Child, Preschool
MH  - Diagnosis, Differential
MH  - Humans
MH  - *Mucocutaneous Lymph Node Syndrome/blood/diagnosis
MH  - Outcome Assessment, Health Care
MH  - SARS-CoV-2
MH  - *Systemic Inflammatory Response Syndrome/blood/diagnosis/etiology/therapy
PMC - PMC8180353
EDAT- 2021/06/07 06:00
MHDA- 2021/12/15 06:00
PMCR- 2021/06/06
CRDT- 2021/06/06 20:48
PHST- 2021/03/04 00:00 [received]
PHST- 2021/05/29 00:00 [revised]
PHST- 2021/05/31 00:00 [accepted]
PHST- 2021/06/07 06:00 [pubmed]
PHST- 2021/12/15 06:00 [medline]
PHST- 2021/06/06 20:48 [entrez]
PHST- 2021/06/06 00:00 [pmc-release]
AID - S0828-282X(21)00290-7 [pii]
AID - 10.1016/j.cjca.2021.05.014 [doi]
PST - ppublish
SO  - Can J Cardiol. 2021 Oct;37(10):1619-1628. doi: 10.1016/j.cjca.2021.05.014. Epub 
      2021 Jun 6.