Following the outbreak of SARS-CoV-2 infection, COVID-19 pandemic is emerging as a global health issue. In this context the scientific community is wondering about a possible correlation between SARS-CoV-2 virus infection and the onset of Kawasaki-like diseases. From studies reported so far, the pediatric population appears to be affected less than adults. In the last period with the increase in number of infections, there have been first reports of KD secondary to SARS-CoV-2 infection [
7], some typical forms, other atypical ones. Shelley Riphagen et al. during a 10-day period in mid-April, in the UK, reported a cluster of 8 children with hyperinflammatory shock syndrome. This cluster of cases formed the basis of a national alarm. They suggest that this clinical picture represents a new phenomenon that affects previously asymptomatic children with SARS-CoV-2 infection manifesting itself as a hyperinflammatory multi-organ involvement syndrome similar to a shock syndrome in KD [
8]. Kawasaki disease shock syndrome (KDSS) is characterized by cardiovascular shock, associated with resistance to immunoglobulins, coronary anomalies and hyperinflammatory state with possible cardiovascular shock [
9]. In studies of adult patients with Covid-19, a subset of patients showed hyperinflammation and multi-organ failure due to excessive release of cytokines caused by an uncontrolled immune response. Similarly, genetically susceptible pediatric patients, after contact with Covid-19, could develop a disease complicated by hyperinflammatory shock. KD, as mentioned above, is known to recognize infectious triggers, most often viruses, and SARS-COV 2, which is, at present, the most common infectious agent in the world, could probably induce the development of epidemic clusters outbreaks by KD. The recorded anomaly could be the significant percentage of severe KD cases: this could be explained by the fact that the typical Covid-19 cytokine storm has a substantial overlap with that of Kawasaki disease, with high levels of IL-1, IL-6 and TNF-alpha, and also the presence of circulating activated macrophages that characterize both the diseases [
10].