Kawasaki like disease in SARS-CoV-2 infected children – a key role for neutrophil and macrophage extracellular traps

Ahmed Yaqinuddin; Abdul Hakim Almakadma; Junaid Kashir; Ahmed Yaqinuddin; Abdul Hakim Almakadma; Junaid Kashir

doi:10.3934/molsci.2021013

AIMS Molecular Science

2021, Volume 8, Issue 3: 174-183. doi: 10.3934/molsci.2021013

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Kawasaki like disease in SARS-CoV-2 infected children – a key role for neutrophil and macrophage extracellular traps

1.
College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
2.
Department of Comparative Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

Received: 19 April 2021 Accepted: 05 July 2021 Published: 08 July 2021

Less than 2% of children are reported to test positive for SARS-CoV-2. However, increasing reports have described COVID-positive children demonstrating symptoms like Kawasaki disease (KD), an acute vasculitis in medium sized vessels. Characteristic clinical features of KD include fever, conjunctivitis, mucosal alterations, rashes, and cervical lymphadenopathy. We searched PubMed with six keywords including neutrophil and macrophage extracellular traps (NETs/METs), Kawasaki disease, vasculitis, COVID-19 and SARS-CoV-2. We discussed here how SARS-CoV-2 infection is accompanied by activation of proinflammatory cytokines, specifically IL-1β and production of neutrophil and macrophage extracellular traps (NETs/METs), structures formed through specialized types of cell death. In this review, we propose that the KD-like pathogenesis observed in COVID-19-infected children could arise from infection of resident macrophages resulting in activation of NLRP3 inflammasomes and release of IL-1β in a genetically predisposed subset of infected children, mediated via NET/MET dysregulation and overproduction. We also propose potential avenues of diagnosis and treatment that could be utilized to aid such patients.
- COVID-19,
- Kawasaki syndrome,
- macrophage extracellular traps,
- neutrophil extracellular traps,
- SARS-CoV-2,
- thrombosis,
- vasculitis
Citation: Ahmed Yaqinuddin, Abdul Hakim Almakadma, Junaid Kashir. Kawasaki like disease in SARS-CoV-2 infected children – a key role for neutrophil and macrophage extracellular traps[J]. AIMS Molecular Science, 2021, 8(3): 174-183. doi: 10.3934/molsci.2021013

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Abstract

Less than 2% of children are reported to test positive for SARS-CoV-2. However, increasing reports have described COVID-positive children demonstrating symptoms like Kawasaki disease (KD), an acute vasculitis in medium sized vessels. Characteristic clinical features of KD include fever, conjunctivitis, mucosal alterations, rashes, and cervical lymphadenopathy. We searched PubMed with six keywords including neutrophil and macrophage extracellular traps (NETs/METs), Kawasaki disease, vasculitis, COVID-19 and SARS-CoV-2. We discussed here how SARS-CoV-2 infection is accompanied by activation of proinflammatory cytokines, specifically IL-1β and production of neutrophil and macrophage extracellular traps (NETs/METs), structures formed through specialized types of cell death. In this review, we propose that the KD-like pathogenesis observed in COVID-19-infected children could arise from infection of resident macrophages resulting in activation of NLRP3 inflammasomes and release of IL-1β in a genetically predisposed subset of infected children, mediated via NET/MET dysregulation and overproduction. We also propose potential avenues of diagnosis and treatment that could be utilized to aid such patients.

Conflict of interest

Authors declare no conflict of interest.

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