SARS-CoV-2 Infection in Children and Kawasaki Disease. What Is the Relationship?

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel virus affecting adults and children. The spread of severe acute respiratory syndrome resulted in a global pandemic by SARS-CoV-2. The pediatric population is responsible for a smaller proportion, and 2% of cases are described under age 20 (1). Whether this ratio is a sign of low sensitivity to the disease in children vs. adults or a higher rate of asymptomatic cases is unclear. Recently, attention has been drawn to the link between Kawasaki-like disease and coronavirus disease-2019 (Covid-19) in children (2). Kawasaki disease (KD) initially described in 1967 in Japan is a multisystem inflammatory syndrome, typically occurs in six months to five years old children. Tomisaku Kawasaki stated that there may be a correlation between viral infection and a cluster of patients with "Mucocutaneous Lymph Node Syndrome", 40 years later, Espar et al. found eight coronavirus-positive nasal swabs among eleven patients with KD (3). Chang et al. have shown that viruses, including coronavirus, has been linked to KD (4). Recently, there is an increasing occurrence of KD potentially linked with coronavirus between children in a high-risk area (5). Cases of multisystem inflammatory syndromes and Kawasaki occurred in Europe and the USA named pediatric inflammatory, multisystem syndrome temporally associated with SARS-CoV-2 infection (PIMS-TS), and multisystem inflammatory syndrome in children (MIS-C), respectively (6).