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Background. Kawasaki disease is an acute and rare febrile disease that affects children and is characterized by conjunctivitis, redness of the lips and mouth, diffuse skin lesions, edema and redness of the hands and feet, and cervical lymphadenopathy. Since the start of the COVID-19 pandemic, Kawasaki disease has become much more prevalent and has more diverse manifestations. Methods. This retrospective cohort study included patients diagnosed with Kawasaki symptoms between January and October 2021 at the Tabriz Children's Education and Therapeutic Center. The diagnosis was made using the guidelines of the American Heart Association (2017) and the American College of Rheumatology. Results. All referred patients had fever, and additional symptoms may include skin involvement (93%), mucosal involvement (87%), end changes in the peripheral exterimities in the form of erythema and scaling (75%), gastrointestinal manifestations (51%), cardiac manifestations (42%), followed by respiratory (27%), and finally cervical lymphadenopathy (18%). Conclusion. Manifestations of Kawasaki disease during the COVID-19 pandemic can be much more diverse and severe. Knowing the variety of clinical symptoms and uncommon findings of Kawasaki disease in these patients can help to early distinguishing between Kawasaki and Kawasaki like disease and prevent the progression of the disease. Practical Implications. It was noteworthy that patients with complete Kawasaki manifestations were less than five years old. The age range of the patients was between 11 months and 13 years, and the average age range was between 5 and 6 years (65±37 months). [ABSTRACT FROM AUTHOR]