Mediterr J Rheumatol 2020;31(Suppl 2):268-74
Kawasaki Disease and COVID-19
Authors Information

1. Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa

2. Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece

Athanasios Gkoutzourelas, Dimitrios P. Bogdanos, Lazaros I. Sakkas


The recent passing away of Dr. Tomisaku Kawasaki, who first described what is now known as Kawasaki Disease (KD), and recent reports of a multisystem inflammatory disease in children associated with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (MIS-C), makes a review on KD and MIS-C timely. Kawasaki Disease is a systemic vasculitis with predilection for coronary arteries occurring mostly in early childhood. The main features are high fever, extensive skin rash, cheilitis with red, cracking, bleeding lips and strawberry tongue, conjunctivitis, erythema and induration of hands and feet, subsiding with periungual peeling, cervical lymphadenopathy, and coronary artery dilation/aneurysms. Treatment consists of intravenous (IV) immunoglobulin (Ig) plus acetylsalicylic acid. MIS-C is considered a cytokine storm with high fever, inflammation, multi-organ dysfunction, that shares features with KD, toxic shock, and macrophage activation syndrome. Many children require admission to paediatric intensive care units for circulatory support. Bacterial sepsis, staphylococcal toxic shock syndrome, and enterovirus-causing myocarditis should be excluded. Treatment is not standardized and includes IVIg, IV methylprednisolone and IL-6 and IL-1 inhibitors.


This work is licensed under a Creative Commons Attribution 4.0 International License (CC-BY). 

Article Submitted: 30 Jun 2020; Revised Form: 8 Sep 2020; Article Accepted: 11 Sep 2020; Available Online: 21 Sep 2020