COVID-19 May Increase Kawasaki Disease Risk

A recent study found there is significantly higher intravenous immune globulin (IVIG) resistance among children who contracted COVID-19 before developing Kawasaki disease (KD).

In the retrospective study that analyzed the impact of COVID-19 infection on KD, researchers analyzed 161 children with KD onset during the COVID-19 pandemic. The proportion of IVIG-resistant individuals and the rate of corticosteroid use in the one to seven weeks from COVID-19 infection to KD onset were higher than that of the noninfected group, even after excluding suspected cases of multiple system inflammatory syndrome. Specifically, 33.8 percent of COVID-19 infected children exhibited IVIG resistance compared to just 15.5 percent among non-infected children. In addition, compared to the noninfected group, the level of CD4 was lower, and the levels of CD3−CD16+CD56+, complement C4, TNF-α and IFN-γ were higher in the one to seven weeks after COVID-19 infection.

Findings suggest not only immediate immune dysregulation following acute COVID-19 infection but potential longer-term ramifications for children’s immune health. “The risk of IVIG resistance was significantly increased in children with KD onset one to seven weeks after COVID-19 infection,” stated the authors of the article, pointing to the necessity for heightened awareness among health professionals. Children recovering from COVID-19 may continue to experience functional impacts on their immune systems, leading to more severe outcomes surrounding conditions like KD. 

Study data also highlighted differences in treatment strategies, with a higher corticosteroid use rate observed among COVID-infected children, where 39.3 percent required corticosteroids compared to 13.1 percent from the noninfected group. According to the researchers, this calls for reconsideration of treatment protocols, particularly concerning early corticosteroid intervention for vulnerable KD patients arising from COVID-19 backgrounds.