{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T20:53:44Z","timestamp":1790110424944,"version":"4.0.1"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,1,9]],"date-time":"2021-01-09T00:00:00Z","timestamp":1610150400000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Pediatrics"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:p>In the early stages of the outbreak of the novel coronavirus disease 2019 (COVID\u201019), it was assumed that this infection is very mild and uncommon in children. However, recent reports have shown that children may also develop the disease and its severe complications. These complications included shock, multisystem inflammatory syndrome in children (MIS\u2010C), and pneumonia in children. A previously healthy 14\u2010month\u2010old boy presented with fever, irritability, and skin rash, besides changes in the lips, conjunctiva, and tongue. His medical history, clinical presentations, treatment, laboratory data, and follow\u2010up information were recorded. He was treated according to the diagnosis of Kawasaki disease (KD). He had a history of close contact with a COVID\u201019 patient. However, the result of reverse transcription\u2010polymerase chain reaction (RT\u2010PCR) assay for COVID\u201019 was negative. Immunoglobulin M for COVID\u201019 was positive (1.20), while immunoglobulin G was negative (0.37). Three weeks later, seroconversion of COVID\u201019 immunoglobulin G (1.42) occurred. Despite treatment with two doses of intravenous immunoglobulin and methylprednisolone, coronary artery ectasia was detected. On the sixth day of hospitalization, the patient experienced hypotension, which necessitated treatment with inotropic drugs and resulted in a change of diagnosis to MIS\u2010C. The later echocardiography showed evidence of coronary artery aneurysm (CAA), which finally changed to giant CAA. Although the patient was treated with infliximab, the size of CAA showed a significant decrease in the one\u2010month follow\u2010up. This is the first report of MIS\u2010C during the COVID\u201019 pandemic in Iran, accompanied by KD, which was complicated with giant CAA.<\/jats:p>","DOI":"10.1155\/2021\/8836403","type":"journal-article","created":{"date-parts":[[2021,1,9]],"date-time":"2021-01-09T18:23:22Z","timestamp":1610216602000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["COVID\u201019\u2010Associated Multisystem Inflammatory Syndrome Complicated with Giant Coronary Artery Aneurysm"],"prefix":"10.1155","volume":"2021","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9752-5484","authenticated-orcid":false,"given":"Mohammad Reza","family":"Navaeifar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3224-6457","authenticated-orcid":false,"given":"Leila","family":"Shahbaznejad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4093-6439","authenticated-orcid":false,"given":"Ali","family":"Sadeghi Lotfabadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4585-9954","authenticated-orcid":false,"given":"Mohammad Sadegh","family":"Rezai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,1,9]]},"reference":[{"key":"e_1_2_6_1_2","doi-asserted-by":"publisher","DOI":"10.1111\/apa.15270"},{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-0702"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(20)31094-1"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-1711"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2002032"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.10369"},{"key":"e_1_2_6_7_2","unstructured":"World Health Organization Multisystem inflammatory syndrome in children and adolescents with COVID-19 2020 World Health Organization Geneva Switzerland https:\/\/www.who.int\/publications-detail\/multisystem-inflammatorysyndrome-in-children-and-adolescents-withcovid-19."},{"key":"e_1_2_6_8_2","unstructured":"Centers for Disease Control and Prevention Emergency preparedness and response: health alert network 2020 Centers for Disease Control and Prevention Atlanta GA USA https:\/\/emergency.cdc.gov\/han\/2020\/han00432.asp."},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(20)31129-6"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2020.04.052"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.acvd.2019.10.008"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.2188\/jea.JE20140089"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.10374"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.32598\/jpr.8.2.139"},{"key":"e_1_2_6_15_2","unstructured":"European Centre for Disease Prevention and Control Rapid risk assessment: paediatric inflammatory multisystem syndrome and SARS -CoV-2 infection in children 2020 European Centre for Disease Prevention and Control Solna Municipality Sweden https:\/\/www.ecdc.europa.eu\/en\/publications-data\/paediatricinflammatory-multisystem-syndrome-and-sarscov-2-rapid-risk-assessment."},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.2147\/imcrj.s262935"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-009-0925-0"},{"key":"e_1_2_6_18_2","first-page":"44","article-title":"Intravenous immunoglobulin resistant Kawasaki disease","volume":"1","author":"Navaeifar M. 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