Distinguishing Between Multisystem Inflammatory Syndrome, Associated With COVID-19 in Children and the Kawasaki Disease: Development of Preliminary Criteria Based on the Data of the Retrospective Multicenter Cohort Study

Objectives: Diagnostic between multisystem inflammatory syndrome associated with COVID-19 in children (MIS-C) and Kawasaki disease (KD) can make difficulties due to many similarities. Our study aimed to create a Kawasaki/MIS-C differentiation score (KMDscore) allowing discrimination of MIS-C and KD....

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Autores principales:	Mikhail M. Kostik, Liudmila V. Bregel, Ilia S. Avrusin, Elena A. Dondurei, Alla E. Matyunova, Olesya S. Efremova, Eugenia A. Isupova, Tatiana L. Kornishina, Vera V. Masalova, Ludmila S. Snegireva, Vladimir V. Shprakh, Yuri A. Kozlov, Olga V. Kalashnikova, Vyacheslav G. Chasnyk
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	multisystem inflammatory syndrome Kawasaki disease children hypercytokine syndrome cytokine storm syndrome COVID-19 Pediatrics RJ1-570
Acceso en línea:	https://doaj.org/article/8800b76450414f83ba59d3a5eff792e9
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spelling	oai:doaj.org-article:8800b76450414f83ba59d3a5eff792e92021-11-10T08:20:24ZDistinguishing Between Multisystem Inflammatory Syndrome, Associated With COVID-19 in Children and the Kawasaki Disease: Development of Preliminary Criteria Based on the Data of the Retrospective Multicenter Cohort Study2296-236010.3389/fped.2021.787353https://doaj.org/article/8800b76450414f83ba59d3a5eff792e92021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fped.2021.787353/fullhttps://doaj.org/toc/2296-2360Objectives: Diagnostic between multisystem inflammatory syndrome associated with COVID-19 in children (MIS-C) and Kawasaki disease (KD) can make difficulties due to many similarities. Our study aimed to create a Kawasaki/MIS-C differentiation score (KMDscore) allowing discrimination of MIS-C and KD.Study design: The retrospective multicenter cohort study included clinical, laboratory, and instrumental information about MIS-C (n = 72) and KD (n = 147). The variables allowed to discriminate both conditions used to construct and validate the diagnostic score called the KMDscore.Results: Patients with MIS-C were older, had earlier admission to the hospital, had a shorter time before fever resolution, two times frequently had signs of GI and CNS involvement observed, and had more impressive thrombocytopenia, higher level of CRP, ferritin, ALT, AST, LDH, creatinine, triglycerides, troponin, and D-dimer compared to KD patients. Respiratory signs in MIS-C were presented with pleuritis, acute respiratory distress syndrome, oxygen dependency, lung infiltration, and ground-glass opacities in CT. The heart involvement with fast progression of myocarditis provided the severity of MIS-C and ICU admission due to 12 times higher arterial hypotension or shock and required cardiotonic. No differences in the frequency of CA lesions were seen in the majority of cases. Five criteria, CRP >11 mg/dl (18 points), D-dimer >607 ng/ml (27 points), age >5 years (30 points), thrombocytopenia (25 points), and GI involvement (28 points), were included in the KMDscore. The summa >55 points allowed to discriminate MIS-C from KD with a sensitivity of 87.5% and specificity of 89.1%.Conclusion: The KMDscore can be used to differentiate the diagnostic of MIS-C from KD.Mikhail M. KostikLiudmila V. BregelLiudmila V. BregelIlia S. AvrusinElena A. DondureiElena A. DondureiAlla E. MatyunovaOlesya S. EfremovaEugenia A. IsupovaTatiana L. KornishinaVera V. MasalovaLudmila S. SnegirevaVladimir V. ShprakhYuri A. KozlovOlga V. KalashnikovaVyacheslav G. ChasnykFrontiers Media S.A.articlemultisystem inflammatory syndromeKawasaki diseasechildrenhypercytokine syndromecytokine storm syndromeCOVID-19PediatricsRJ1-570ENFrontiers in Pediatrics, Vol 9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	multisystem inflammatory syndrome Kawasaki disease children hypercytokine syndrome cytokine storm syndrome COVID-19 Pediatrics RJ1-570
spellingShingle	multisystem inflammatory syndrome Kawasaki disease children hypercytokine syndrome cytokine storm syndrome COVID-19 Pediatrics RJ1-570 Mikhail M. Kostik Liudmila V. Bregel Liudmila V. Bregel Ilia S. Avrusin Elena A. Dondurei Elena A. Dondurei Alla E. Matyunova Olesya S. Efremova Eugenia A. Isupova Tatiana L. Kornishina Vera V. Masalova Ludmila S. Snegireva Vladimir V. Shprakh Yuri A. Kozlov Olga V. Kalashnikova Vyacheslav G. Chasnyk Distinguishing Between Multisystem Inflammatory Syndrome, Associated With COVID-19 in Children and the Kawasaki Disease: Development of Preliminary Criteria Based on the Data of the Retrospective Multicenter Cohort Study
description	Objectives: Diagnostic between multisystem inflammatory syndrome associated with COVID-19 in children (MIS-C) and Kawasaki disease (KD) can make difficulties due to many similarities. Our study aimed to create a Kawasaki/MIS-C differentiation score (KMDscore) allowing discrimination of MIS-C and KD.Study design: The retrospective multicenter cohort study included clinical, laboratory, and instrumental information about MIS-C (n = 72) and KD (n = 147). The variables allowed to discriminate both conditions used to construct and validate the diagnostic score called the KMDscore.Results: Patients with MIS-C were older, had earlier admission to the hospital, had a shorter time before fever resolution, two times frequently had signs of GI and CNS involvement observed, and had more impressive thrombocytopenia, higher level of CRP, ferritin, ALT, AST, LDH, creatinine, triglycerides, troponin, and D-dimer compared to KD patients. Respiratory signs in MIS-C were presented with pleuritis, acute respiratory distress syndrome, oxygen dependency, lung infiltration, and ground-glass opacities in CT. The heart involvement with fast progression of myocarditis provided the severity of MIS-C and ICU admission due to 12 times higher arterial hypotension or shock and required cardiotonic. No differences in the frequency of CA lesions were seen in the majority of cases. Five criteria, CRP >11 mg/dl (18 points), D-dimer >607 ng/ml (27 points), age >5 years (30 points), thrombocytopenia (25 points), and GI involvement (28 points), were included in the KMDscore. The summa >55 points allowed to discriminate MIS-C from KD with a sensitivity of 87.5% and specificity of 89.1%.Conclusion: The KMDscore can be used to differentiate the diagnostic of MIS-C from KD.
format	article
author	Mikhail M. Kostik Liudmila V. Bregel Liudmila V. Bregel Ilia S. Avrusin Elena A. Dondurei Elena A. Dondurei Alla E. Matyunova Olesya S. Efremova Eugenia A. Isupova Tatiana L. Kornishina Vera V. Masalova Ludmila S. Snegireva Vladimir V. Shprakh Yuri A. Kozlov Olga V. Kalashnikova Vyacheslav G. Chasnyk
author_facet	Mikhail M. Kostik Liudmila V. Bregel Liudmila V. Bregel Ilia S. Avrusin Elena A. Dondurei Elena A. Dondurei Alla E. Matyunova Olesya S. Efremova Eugenia A. Isupova Tatiana L. Kornishina Vera V. Masalova Ludmila S. Snegireva Vladimir V. Shprakh Yuri A. Kozlov Olga V. Kalashnikova Vyacheslav G. Chasnyk
author_sort	Mikhail M. Kostik
title	Distinguishing Between Multisystem Inflammatory Syndrome, Associated With COVID-19 in Children and the Kawasaki Disease: Development of Preliminary Criteria Based on the Data of the Retrospective Multicenter Cohort Study
title_short	Distinguishing Between Multisystem Inflammatory Syndrome, Associated With COVID-19 in Children and the Kawasaki Disease: Development of Preliminary Criteria Based on the Data of the Retrospective Multicenter Cohort Study
title_full	Distinguishing Between Multisystem Inflammatory Syndrome, Associated With COVID-19 in Children and the Kawasaki Disease: Development of Preliminary Criteria Based on the Data of the Retrospective Multicenter Cohort Study
title_fullStr	Distinguishing Between Multisystem Inflammatory Syndrome, Associated With COVID-19 in Children and the Kawasaki Disease: Development of Preliminary Criteria Based on the Data of the Retrospective Multicenter Cohort Study
title_full_unstemmed	Distinguishing Between Multisystem Inflammatory Syndrome, Associated With COVID-19 in Children and the Kawasaki Disease: Development of Preliminary Criteria Based on the Data of the Retrospective Multicenter Cohort Study
title_sort	distinguishing between multisystem inflammatory syndrome, associated with covid-19 in children and the kawasaki disease: development of preliminary criteria based on the data of the retrospective multicenter cohort study
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/8800b76450414f83ba59d3a5eff792e9
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Distinguishing Between Multisystem Inflammatory Syndrome, Associated With COVID-19 in Children and the Kawasaki Disease: Development of Preliminary Criteria Based on the Data of the Retrospective Multicenter Cohort Study

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