Multisystem inflammatory syndrome in children is a SARS-CoV-2 triggered Kawasaki disease
KD and MIS-C are not separate entities but different ends of the immune response spectrum. Among the hyperinflammation spectrum, each viral variant induces a distinct MIS-C phenotype, with the Omicron wave resembling KD. Clinical phenotype stratification outperformed MIS-C definitions in identifying patient subgroups, confirming the value of clinical features in managing infection-triggered hyperinflammation. The inverse relationship between pre-pandemic KD incidence and MIS-C reporting supports MIS-C being a SARS-CoV-2-triggered KD, underscoring critical equity and diversity considerations. A pathogen-agnostic approach to post-infectious hyperinflammation would recognize the full spectrum of phenotypes and complications and avoid confusion due to new naming conventions.
Authors
- Paul Tsoukas (ORCID: https://orcid.org/0000-0002-1782-4458)
- Greta Mastrangelo (ORCID: https://orcid.org/0000-0002-3455-7304)
- Rae S. M. Yeung (ORCID: https://orcid.org/0000-0003-2361-725X)
- Amy Xu (ORCID: https://orcid.org/0000-0001-8294-3886)
- Arthur H. Cheng (ORCID: https://orcid.org/0000-0001-8214-1437)
- Hua Lu (ORCID: https://orcid.org/0000-0003-1199-6678)
- Ellen Go (ORCID: https://orcid.org/0000-0001-8234-3047)
Institutions
- Indiana University Health (US)
- St. Michael's Hospital (CA)
- University of Toronto (CA)
- Children's Hospital of Eastern Ontario (CA)
- Hospital for Sick Children (CA)
- Centre Hospitalier Universitaire Sainte-Justine (CA)
- SickKids Foundation (CA)
Publication Details
- Journal
- Pediatric Research
- Published
- 2025-10-27
- DOI
- https://doi.org/10.1038/s41390-025-04499-8
- Citations
- 2
- Primary Topic
- Kawasaki Disease and Coronary Complications
- Type
- article
- Field-Weighted Citation Impact
- 4.01
Funders
- University of Toronto
- Hospital for Sick Children
- Canadian Institutes of Health Research