Cardiovascular impact of COVID-19 with a focus on children: A systematic review

Table 4 Differential characteristics between Kawasaki disease and the novel Pediatric Multisystem Inflammatory Syndrome in children with SARS-CoV-2 infection

Characteristic	Kawasaki disease	PMIS
Age	6 mo-5 yr (most cases under 2-yr-old)	School-aged children (mean age 9-yr-old)
Sex	Male predominance	Male = Female
Race	Asiatic	African/Caribbean
Region	Most cases at Asia	Most cases at Europe and America. No asiatic cases
Seasonality	Spring-Autum	Regional incidences associated with the larger regional COVID-19 outbreaks
Related with acute infection	Yes	2-4 wk after primary infection (can occur also during acute phase)
Incomplete KD criteria	Up to 30%	< 25%
Gastrointestinal symptoms	Uncommon	Almost 100%
KD shock syndrome	2%-7%	50%-60%
Increased inflammatory biomarkers (CRP, Procalcitonin, Ferritin)	++	++++
Lymphocyte count	Lymphopenia rare	Lymphopenia in up to 80%
Platelet count	Thrombocytosis	Thrombocytopenia
Coagulation indexes	Normal values	Increased indexes; Very increased Dimer-D levels
Increased cardiac biomarkers	Natriuretic peptides (> 50%) ++; cTn (< 20%-30%) +/-	Natriuretic peptides (87%) ++++; cTn (73%) ++++
Myocardial dysfunction	< 1%	Up to 52%
Coronary arteries anomalies	25% without adequate treatment	15%
IVIG resistance	10%-20%	50%-60%
Biologic therapy	Very rare	15 %
Long-term Cardiac sequel	< 5% with adequate treatment	5.5%
PICU admission	4%-5%	75%
Mechanical Ventilation	Very rare	22 %
ECMO support	Extremely rare	4%-5%
Exitus or Sequelae	< 1%	2%

COVID-19: Coronavirus disease-2019; CRP: C-reactive protein; IVIG: Intravenous immunoglobulin; PICU: Pediatric intensive care unit; ECMO: Extracorporeal membrane oxygenation.