COVID-19 and Kawasaki Disease: A Meta-Analysis and Systematic Review of Case-Reports and Case-Series

BACKGROUND: The incidence of Kawasaki disease has increased 13-30 times during the COVID-19 pandemic. Kawasaki disease is a self-limiting vasculitis, that can lead to acquired cardiac disease if left untreated. Identifying risk factors for children likely to develop Kawasaki disease during the COVID-19 pandemic is imperative to aid diagnosis. METHODS: A systematic review and meta-analysis were performed of 9 suitable case report/series, describing a total of 45 patients diagnosed with Kawasaki disease associated with COVID-19 globally. We systematically analysed the data of demographics, clinical features, comorbidities, laboratory findings, treatment administered, clinical progression and fatality FINDINGS: Mean age of children was 7.9 years, with a male to female ratio of 3:2. The demographics showed a disproportionate representation of obesity and BAME (Black, Asian, Minority Ethnic) groups in this patient cohort, which was statistically significant. INTERPRETATION: Kawasaki disease should be considered early in children with fever for more than 5 days (+/- gastrointestinal symptoms), especially in high risk patients, such as BAME groups, male gender and high BMI.