• J-C Mercier, A Maroni, M Levy, I Melki, U Meinzer, J Gaschignard, C Beyler, and A Santos.
• Professeur émérite, Université de Paris, Plateforme COVIDOM, AP-HP, ARS Île de France, Hôpital Robert Debré, Assistance Publique-Hôpitaux de Paris, 47, rue Copernic, 75116 Paris, France.
• B Acad Nat Med Paris. 2021 Jun 1; 205 (6): 579586579-586.

AbstractSARS-CoV-2 pandemics is characterized by a high level of infectivity and a high mortality among adults at risk (older than 65 years, obesity, diabetes, systemic hypertension). Following a common viral pneumonia, a multisystem inflammatory syndrome sometimes occurs, including an Acute Respiratory Distress Syndrome (ARDS) carrying a high mortality. Unlike most common respiratory viruses, children seem less susceptible to SARS-CoV-2 infection and generally develop a mild disease with low mortality. However, clusters of severe shock associated with high levels of cardiac biomarkers and unusual vasoplegia requiring inotropes, vasopressors and volume loading have been recently described. Both clinical symptoms (i.e., high and persistent fever, gastrointestinal disorders, skin rash, conjunctivitis and dry cracked lips) and biological signs (e.g., elevated CRP/PCT, hyperferritinemia) resembled Kawasaki disease. In most instances, intravenous immunoglobin therapy improved the cardiac function and led to full recovery within a few days. However, adjunctive steroid therapy and sometimes biotherapy (e.g., anti-IL-1Ra, anti-IL-6 monoclonal antibodies) were often necessary. Although almost all children fully recovered within a week, some of them developed coronary artery dilation or aneurysm. Thus, a new 'Multisystem Inflammatory Syndrome associated with SARS-CoV-2' has been recently described in children and helps to better understand Kawasaki disease pathophysiology.© 2021 l'Académie nationale de médecine. Published by Elsevier Masson SAS. All rights reserved.

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