A review of coronaviruses associated with Kawasaki Disease: Possible implications for pathogenesis of the Multisystem Inflammatory Syndrome associated with COVID-19

Authors

Fatima Farrukh Shahbaz, Aga Khan UniversityFollow
Russell Seth Martins, Aga Khan UniversityFollow
Abdullah Umair, Aga Khan UniversityFollow
Ronika Devi Ukrani, Aga Khan UniversityFollow
Kauser Jabeen, Aga Khan UniversityFollow
M Rizwan Sohail, Mayo Clinic College of Medicine and Science
Erum Khan, Aga Khan UniversityFollow

Document Type

Review Article

Department

Medical College Pakistan; Pathology and Laboratory Medicine

Abstract

Multisystem Inflammatory Syndrome in Children (MIS-C), representing a new entity in the spectrum of manifestations of COVID-19, bears symptomatic resemblance with Kawasaki Disease (KD). This review explores the possible associations between KD and the human coronaviruses and discusses the pathophysiological similarities between KD and MIS-C and proposes implications for the pathogenesis of MIS-C in COVID-19. Since 2005, when a case-control study demonstrated the association of a strain of human coronavirus with KD, several studies have provided evidence regarding the association of different strains of the human coronaviruses with KD. Thus, the emergence of the KD-like disease MIS-C in COVID-19 may not be an unprecedented phenomenon. KD and MIS-C share a range of similarities in pathophysiology and possibly even genetics. Both share features of a cytokine storm, leading to a systemic inflammatory response and oxidative stress that may cause vasculitis and precipitate multi-organ failure. Moreover, antibody-dependent enhancement, a phenomenon demonstrated in previous coronaviruses, and the possible superantigenic behavior of SARS-CoV-2, possibly may also contribute toward the pathogenesis of MIS-C. Lastly, there is some evidence of complement-mediated microvascular injury in COVID-19, as well as of endotheliitis. Genetics may also represent a possible link between MIS-C and KD, with variations in FcγRII and IL-6 genes potentially increasing susceptibility to both conditions. Early detection and treatment are essential for the management of MIS-C in COVID-19. By highlighting the potential pathophysiological mechanisms that contribute to MIS-C, our review holds important implications for diagnostics, management, and further research of this rare manifestation of COVID-19.

Comments

Abstract, volume, issue, and pagination are not provided by the author/publisher.

Publication (Name of Journal)

Clinical Medicine Insights. Pediatrics

Recommended Citation

Shahbaz, F. F., Martins, R. S., Umair, A., Ukrani, R. D., Jabeen, K., Sohail, M., Khan, E. (2022). A review of coronaviruses associated with Kawasaki Disease: Possible implications for pathogenesis of the Multisystem Inflammatory Syndrome associated with COVID-19. Clinical Medicine Insights. Pediatrics.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_mc/261