Document Type

Article

Publication Date

5-6-2025

Identifier

DOI: 10.1161/JAHA.124.037761

Abstract

BACKGROUND: There is significant overlap in clinical features between multisystem inflammatory syndrome in children (MIS-C) and Kawasaki disease (KD). We sought to compare the prevalence, severity, and associated factors for coronary artery (CA) involvement.

METHODS AND RESULTS: From January 1, 2020 through January 31, 2023, 1191 patients with MIS-C and 554 patients contemporaneously diagnosed with KD were enrolled into the International Kawasaki Disease Registry. Demographic and clinical features, laboratory values, maximum Z score in any CA branch +2.5 or greater) were determined separately for each diagnosis using multivariable logistic regression analyses. The prevalence of CA aneurysms was lower for MIS-C versus KD (16% versus 25%, respectively; P< 0.001) and less severe by size category (1.2% with medium/large CA aneurysm versus 9.6%, respectively). Male sex and lower nadir hemoglobin levels were associated with greater odds of CA aneurysms for both groups. Additional associated factors for KD patients included age< 6 months, fewer clinical KD criteria (more incomplete presentation), presentation with shock, and greater total days of fever. There were no additional associated factors for patients with MIS-C. Using exploratory splines, there was a trend of improvement in Z scores within 30 days of illness for both MIS-C and KD for CA involvement other than large aneurysms.

CONCLUSIONS: CA involvement for patients with MIS-C was less prevalent and milder in severity compared with contemporaneous patients with KD, with fewer associated factors, and a high prevalence of regression to a normal luminal dimension.

Journal Title

J Am Heart Assoc

Volume

14

Issue

9

First Page

037761

Last Page

037761

MeSH Keywords

Humans; Mucocutaneous Lymph Node Syndrome; Male; Female; Systemic Inflammatory Response Syndrome; Child, Preschool; Infant; Prevalence; Coronary Aneurysm; Registries; Child; Severity of Illness Index; Risk Factors; Coronary Vessels; Retrospective Studies; Coronary Artery Disease; COVID-19

PubMed ID

40265601

Keywords

Kawasaki disease; Kawasaki disease registry; coronary aneurysm

Comments

This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

Publisher's Link: https://doi.org/10.1161/jaha.124.037761

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