Objectives To describe the characteristics of children and adolescents affected by an outbreak of Kawasaki-like multisystem inflammatory syndrome and to evaluate a potential temporal association with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Design Prospective observational study. Setting General paediatric department of a university hospital in Paris, France. Participants 21 children and adolescents (aged ≤18 years) with features of Kawasaki disease who were admitted to hospital between 27 April and 11 May 2020 and followed up until discharge by 15 May 2020. Main outcome measures The primary outcomes were clinical and biological data, imaging and echocardiographic findings, treatment, and outcomes. Nasopharyngeal swabs were prospectively tested for SARS-CoV-2 using reverse transcription-polymerase chain reaction (RT-PCR) and blood samples were tested for IgG antibodies to the virus. Results 21 children and adolescents (median age 7.9 (range 3.7-16.6) years) were admitted with features of Kawasaki disease over a 15 day period, with 12 (57%) of African ancestry. 12 (57%) presented with Kawasaki disease shock syndrome and 16 (76%) with myocarditis. 17 (81%) required intensive care support. All 21 patients had noticeable gastrointestinal symptoms during the early stage of illness and high levels of inflammatory markers. 19 (90%) had evidence of recent SARS-CoV-2 infection (positive RT-PCR result in 8/21, positive IgG antibody detection in 19/21). All 21 patients received intravenous immunoglobulin and 10 (48%) also received corticosteroids. The clinical outcome was favourable in all patients. Moderate coronary artery dilations were detected in 5 (24%) of the patients during hospital stay. By 15 May 2020, after 8 (5-17) days of hospital stay, all patients were discharged home. Conclusions The ongoing outbreak of Kawasaki-like multisystem inflammatory syndrome among children and adolescents in the Paris area might be related to SARS-CoV-2. In this study an unusually high proportion of the affected children and adolescents had gastrointestinal symptoms, Kawasaki disease shock syndrome, and were of African ancestry.

中文翻译：

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法国巴黎covid-19大流行期间儿童川崎样多系统炎性综合征：前瞻性观察研究。

目的描述受川崎样多系统炎性综合征暴发影响的儿童和青少年的特征，并评估其与严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染的潜在时间关联。设计前瞻性观察研究。在法国巴黎设置一家大学医院的儿科。参与者2020年4月27日至5月11日入院并随访至2020年5月15日出院的21例川崎病特征的儿童和青少年（≤18岁）。主要结局指标初步结局为临床和生物学数据，影像和超声心动图检查结果，治疗和结果。使用逆转录聚合酶链反应（RT-PCR）对鼻咽拭子进行了SARS-CoV-2前瞻性测试，并对血液样本进行了针对该病毒的IgG抗体测试。结果在15天的时间里，有21名儿童和青少年（中位年龄为7.9岁（范围3.7-16.6））被录取患有川崎病，其中12例（57％）来自非洲。川崎病休克综合征为12（57％），心肌炎为16（76％）。17（81％）位人士需要重症监护服务。所有21例患者在疾病早期都有明显的胃肠道症状，并且炎症标记物含量很高。19（90％）有近期SARS-CoV-2感染的证据（RT / PCR阳性为8/21，IgG抗体阳性为19/21）。所有21例患者均接受了静脉免疫球蛋白治疗，其中10例（48％）也接受了皮质类固醇激素治疗。所有患者的临床结果均良好。在住院期间，有5名（24％）患者检测到中度冠状动脉扩张。到2020年5月15日，在住院8（5-17）天后，所有患者均已出院。结论巴黎地区儿童和青少年中川崎样多系统炎性综合征的持续爆发可能与SARS-CoV-2有关。在这项研究中，异常高比例的患儿和青少年具有胃肠道症状，川崎病休克综合征，并且具有非洲血统。结论巴黎地区儿童和青少年中川崎样多系统炎性综合征的持续爆发可能与SARS-CoV-2有关。在这项研究中，异常高比例的患儿和青少年具有胃肠道症状，川崎病休克综合征，并且具有非洲血统。结论巴黎地区儿童和青少年中川崎样多系统炎性综合征的持续爆发可能与SARS-CoV-2有关。在这项研究中，异常高比例的患儿和青少年具有胃肠道症状，川崎病休克综合征，并且具有非洲血统。