E68 Kawasaki Disease before and during COVID-19

Abstract Introduction Kawasaki disease is a febrile systemic vasculitis of children, which is suspected to be triggered by respiratory viral infections. We further note, with the outbreak of COVID 19, an increase in incidence with a change in the profile of Kawasaki disease. Objective To describe the epidemiological, clinical and evolutionary characteristics of children managed for Kawasaki or Kawasaki-Like syndrome before and during the Covid pandemic19. Materials and Methods This is a retrospective, descriptive study conducted in the PUC department of the Béchir Hamza children's hospital in Tunis, over a period of 05 years from 1 January 2017–31 December 2021. Results We collected 30 cases of patients hospitalized with Kawasaki disease, between January 2017 and December 2021: 11 cases with Kawasaki syndrome before COVID-19; and 19 cases with Kawasaki syndrome after COVID-19. The mean age of diagnosis was 42 months before the pandemic vs 81 months after the pandemic. The sex ratio was 0.5 before the pandemic vs 0.7 after the pandemic. Viral disease was reported in 0 cases before the pandemic vs 4 cases with confirmed COVID contacts after the pandemic. Fever was the main symptom in both periods, with a mean maximum temperature of 39.7°C before the pandemic vs 39.5°C after the pandemic. The delay of fever from diagnosis was 7.8 days before the pandemic vs 5 days after the pandemic. Cheilitis was reported in 10 cases before the pandemic vs 16 case after the pandemic. Palmoplantarerythema was reported in 1 case before the pandemic vs 7 cases after the pandemic. Scaling was found in 8 cases before the pandemic vs 2 cases after the pandemic. The rash was reported in 9 cases mainly purpuric before the pandemic vs 17 cases after the pandemic, maculopapular. Abdominal involvement was found in 2 cases before the pandemic vs 14 cases after the pandemic. Clinical cardiac involvement was found in 2 cases before the pandemic vs 3 cases after the pandemic. The TTE was pathological in 2 cases before the pandemic, with coronary aneurysm vs 7 cases after the pandemic, with heart failure. All cases received immunoglobulin with a mean time to apyrexia of 26 h before the pandemic vs 25 h after the pandemic. The mean time to hospitalization was 8 days before the pandemic vs 7.3 days after the pandemic. No deaths occurred. Conclusion The change in the profile and incidence of Kawasaki disease following the emergence of COVID-19 must be taken into account in order to manage an influx of patients with severe Kawasaki disease.