16 Comparison of children with kawasaki disease and MIS-C

The goal of this research was to compare clinical signs, symptoms and laboratory findings in children diagnosed with Kawasaki disease and those with multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 (COVID-19).We reviewed medical records of children diagnosed with Kawasaki disease or MIS-C hospitalised in the University Hospital for Infectious Diseases ‘’Dr. Fran Mihaljevic’’ in the period from February 25th 2020 to February 24th 2021. We defined MIS-C using World Health Organisation criteria.There were 13 children diagnosed with Kawasaki disease and 23 children diagnosed with MIS-C hospitalised in this period. The average duration of hospitalisation was similar in both groups, approximately 8 days. Boys were overall more affected (66%) than girls. Children with MIS-C were older and more often gastrointestinal symptoms were present. When comparing laboratory results, children in the MIS-C group had higher C-reactive protein levels and lower platelet count. Also, they required intensive care treatment more frequently. The first therapy of choice for all children with Kawasaki disease was monotherapy with intravenous immunoglobulins (IVIG). Monotherapy with IVIG was used in 15 patients with MIS-C, while 8 of them were initially treated with the combination of IVIG and corticosteroids. One death case occured in the MIS-C group, and none in the Kawasaki group.Multisystem inflammatory syndrome in children associated with COVID-19 is a new pediatric disease that is dangerous and potentially lethal. Although many clinical and laboratory findings overlap with Kawasaki disease, this disease requires intensive care treatment more often. It can also have a fatal outcome – therefore prompt recognition and early treatment are crucial.