Kawasaki Disease and Pediatric Infectious Diseases During the Coronavirus Disease 2019 Pandemic

Ae, Ryusuke; Shibata, Yoshihide; Kosami, Koki; Nakamura, Yosikazu; Hamada, Hiromichi

doi:10.1016/j.jpeds.2021.07.053

Cited by 42 publications

(69 citation statements)

References 48 publications

(105 reference statements)

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“…However, in the acute phase of the outbreak, the number of patients over 5 years of age decreased, and the number of patients under 1 year of age increased. In addition, a study in Japan showed that during periods of social alienation, the decline in older KD children was greater than that in KD infants (<1 year), resulting in a significant difference in the proportion of infants between 2020 and 2017–2019 ( 27 ), which was consistent with our results. This also indicates that the incidence of Kawasaki disease is closely related to infection.…”

Section: Discussionsupporting

confidence: 91%

Characteristics of Kawasaki Disease Before and After the COVID-19 Pandemic in a Large Pediatric Heart Disease Center

Xia

et al. 2022

Front. Pediatr.

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BackgroundKawasaki disease (KD) is an acute febrile systemic vasculitis of unknown etiology. After the pandemic of coronavirus disease 2019 (COVID-19), some children infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) showed clinical symptoms similar to KD, indicating a close relationship between KD and SARS-CoV-2. Therefore, we designed this retrospective study to analyze the characteristics of KD patients before and after the COVID-19 pandemic.MethodsWe retrospectively collected demographic and laboratory data of KD patients in Yuying Children's Hospital of Wenzhou Medical University from 1 January 2015 to 31 December 2020. Yuying Children's Hospital of Wenzhou Medical University is located in eastern China and is the largest pediatric heart disease center in the region, which includes a population of nearly 10 million. We studied the characteristics of KD patients and analyzed the changes in these characteristics before and after the emergence of SARS-CoV-2 in this area.ResultsThe analysis revealed the following novel features: (1) Under the influence of the COVID-19 pandemic, the onset age of Kawasaki disease became younger. (2) After the occurrence of COVID-19, the hospitalization days of KD patients were shorter than before the pandemic. (3) After the occurrence of COVID-19, the albumin of KD patients was higher than before the pandemic. (4) The COVID-19 pandemic did not have a significant effect on the incidence of coronary artery lesions (CALs) in Kawasaki disease.ConclusionAfter the COVID-19 outbreak, the characteristics of KD patients showed a younger trend of age, shorter hospitalization days and higher levels of albumin, but the incidence of CALs did not change significantly.

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Section: Discussionsupporting

confidence: 91%

Characteristics of Kawasaki Disease Before and After the COVID-19 Pandemic in a Large Pediatric Heart Disease Center

Xia

et al. 2022

Front. Pediatr.

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“…Of these, two multicenter studies reported reductions of 47.1% and 53%, respectively, and one nationwide study reported a reduction of 35%. 21 22 23 These studies compared data from 2020 to records from the last 3–5 years. However, they were all focused on the correlation between KD and infectious diseases, and lack a discussion of changes in the clinical features of KD.…”

Section: Discussionmentioning

confidence: 99%

“… 4 Similar hypotheses have been proposed in previous studies. 22 23 After the first case of COVID-19 in Korea, a high number of people started wearing masks and refrained from going out even before the government officially declared that social distancing was necessary, 7 which led to a nationwide decrease in respiratory infections. 24 In addition, at our institution, there was an immediate decrease in emergency room visits for pediatric infectious diseases after the first case of COVID-19.…”

Section: Discussionmentioning

confidence: 99%

“… 27 28 However, some previous studies have suggested that the reluctance of caregivers and patients to visit a hospital for fear of exposure to the virus was not associated with the reduced incidence of KD. 23 29 One of these studies inferred that caregivers would not delay visits to the hospital due to the serious clinical presentation of KD; another study suggested that there was no difference in the duration of fever (in days) at the time of admission. In our sample, the length of hospital stay of patients with KD was significantly shortened after COVID-19, but this was not true for refractory KD.…”

Section: Discussionmentioning

confidence: 99%

“…For this reason, the decrease in the number of patients with KD during the COVID-19 pandemic may be less pronounced in these children than in other age groups. 23 However, our study was not designed to investigate this question, since it is only one of several factors we assessed, and further research is therefore needed.…”

Section: Discussionmentioning

confidence: 99%

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Changes in the Clinical Characteristics of Kawasaki Disease After Coronavirus Disease (COVID-19) Pandemic: A Database Analysis

et al. 2022

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Background The impact of the coronavirus disease 2019 (COVID-19) pandemic on Kawasaki disease (KD) has not yet been established. We investigated changes in the observed number and severity of KD cases and accompanying coronary artery complications during the COVID-19 pandemic in Korea. Methods This retrospective observational study included patients aged < 18 years with acute-phase KD diagnosed between March 2018 and February 2021. Data were extracted from the Clinical Data Warehouse that houses data from five affiliated university hospitals in Korea. We analyzed changes in the number of patient admissions and clinical characteristics, including cardiac complications, before and after the onset of the COVID-19 pandemic. Results A total of 475 admissions were included in the analysis. After March 2020, we observed a significant decrease of 33% in the number of hospitalizations for KD compared with the average number of hospitalizations during the previous 2 years. The number of admissions per month significantly decreased by 7.9 persons/month (95% confidence interval, −13.8 to −2.0; P < 0.05) compared with that before COVID-19. By contrast, the proportion of patients aged < 1 year with KD increased. The proportion of patients with refractory KD and the rate of cardiac complications did not change significantly. Conclusion Since the onset of the COVID-19 pandemic, the total number of hospital admissions for KD has decreased in Korea. Although the proportion of admissions of infants aged < 1 year increased, no changes were observed in clinical courses and complications.

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Epidemiological and Clinical Features of Kawasaki Disease During the COVID-19 Pandemic in the United States

et al. 2022

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Key Points Question How did the incidence and nature of Kawasaki disease (KD) in the United States change during the COVID-19 pandemic? Findings In this cohort study of 3922 children with KD, cases of KD across the United States fell by 28% and remained low during periods of COVID-19–related masking and school closure. In the San Diego region, there was a disproportionate decline in KD cases in children aged 1 to 5 years, male children, and Asian children, and clinical features including strawberry tongue, enlarged cervical lymph node, and subacute periungual desquamation were rare. Meaning These findings suggest that social behavior is associated with exposure to the agent(s) that trigger KD and are consistent with a respiratory portal of entry for the agent(s).

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Kawasaki Disease and Pediatric Infectious Diseases During the Coronavirus Disease 2019 Pandemic

Cited by 42 publications

References 48 publications

Characteristics of Kawasaki Disease Before and After the COVID-19 Pandemic in a Large Pediatric Heart Disease Center

Characteristics of Kawasaki Disease Before and After the COVID-19 Pandemic in a Large Pediatric Heart Disease Center

Changes in the Clinical Characteristics of Kawasaki Disease After Coronavirus Disease (COVID-19) Pandemic: A Database Analysis

Epidemiological and Clinical Features of Kawasaki Disease During the COVID-19 Pandemic in the United States

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