- For pediatric patients with COVID-19 who develop a rare Kawasaki-like syndrome, the American Heart Association (AHA) has published key recommendations from an international panel discussion that took place on May 2, 2020.
- The Pediatric Intensive Care-COVID-19 International Collaborative presented the panel, which included representatives from the AHA’s Young Hearts Council, among others.
Why this matters
- Most children with COVID-19 will be asymptomatic or have a mild disease course, the AHA said in a news release.
- Since March, however, reports have emerged of a rare, Kawasaki-like presentation in a relatively small number of children, with some deaths.
- Kawasaki can lead to heart damage and to coronary artery damage that can persist.
- Case definition: presentation includes persistent fever, inflammation (per cell counts, sequential biomarkers, cytokine panels, antibody testing where available), organ dysfunction.
- Exclude other microbial causes.
- SARS-CoV-2 testing has been negative in some cases, despite confirmed exposure.
- Patients will require multidisciplinary care, including from cardiology and infectious disease specialists.
- Serial echocardiography of coronary arteries is recommended; arteries may be enlarged.
- Tertiary centers or cardiac ICUs are necessary for care because of potential for rapid deterioration.
- Enroll children where applicable in research protocols associated with biobanking.
- Follow carefully all children with unexplained fever, elevated C-reactive protein/white blood cell count to monitor for progression or sudden worsening, even in apparently mild cases.