Little is known about mucocutaneous disease in acutely ill children and adolescents with COVID-19 and multisystem inflammatory syndrome in children (MIS-C).
To characterize mucocutaneous disease and its relation to clinical course among hospitalized patients with COVID-19 and MIS-C.
Descriptive cohort study of prospectively and consecutively hospitalized eligible patients between May 11, 2020 and June 5, 2020.
In COVID-19 patients, 4 of 12 (33%) had rash and/or mucositis, including erythema, morbilliform pattern, and lip mucositis. In MIS-C patients, 9 of 19 (47%) had rash and/or mucositis, including erythema, morbilliform, retiform purpura, targetoid and urticarial patterns, along with acral edema, lip mucositis, tongue papillitis, and conjunctivitis. COVID-19 patients with rash had less frequent respiratory symptoms, pediatric intensive care unit admission, invasive ventilation, and shorter stay versus COVID-19 patients without rash. MIS-C patients with rash had less frequent pediatric intensive care unit admission, shock, ventilation, as well as lower levels of C-reactive protein, ferritin, D-dimer, and troponin (vs MIS-C without rash). Neutrophil-to-lymphocyte ratio was similar for patients with and without rash in both groups. None of the MIS-C patients met criteria for Kawasaki disease.
Small sample sizes.
Mucocutaneous disease is common among children and adolescents with COVID-19 and MIS-C. Laboratory trends observed in patients with rash may prognosticate a less severe course.Le texte complet de cet article est disponible en PDF.
Key words : COVID-19, Kawasaki, MIS-C, multisystem inflammatory syndrome in children, pediatrics, prevalence, rash, SARS-CoV-2
Abbreviations used : IQR, KD, MIS-C, PCR
| Funding sources: None.
| Conflicts of interest: Dr Garg has received honoraria from AbbVie, Amgen, Boehringer Ingelheim, Incyte, Janssen, Novartis, Pfizer, UCB, and Viela Bio. The rest of the authors have no conflicts to disclose.
| IRB approval status: This investigation was approved by the Human Subjects Committee at the Feinstein Institute for Medical Research at the Northwell Health.
| Reprints not available from the authors.