Clinical Evaluations of 49 Cases with Kawasaki Disease: A Retrospective Cohort Study

BackgroundEpidemiological studies in Kawasaki disease (KD) have suggested infectious aetiology. During the COVID-19 pandemic, measures for mitigating SARS-CoV-2 transmission also suppress the circulation of other contagious microorganisms. The primary objective is to compare the number and incidence of KD before and during the COVID-19 pandemic in Japan, and the secondary objective is to investigate temporal association between the KD epidemiology and activities of SARS-CoV-2 and other viral and bacterial infections.MethodsA retrospective cohort study was conducted between 2016 and 2020 in Kobe, Japan. We collected information of hospitalised KD children in Kobe. Child population was identified through the resident registry system. Activity of COVID-19 and 11 other infectious diseases was derived from a public health monitoring system. Monthly change of KD incidence was analysed using a difference-in-difference regression model.ResultsThroughout the study period, 1027 KD children were identified. KD had begun to decline in April 2020, coinciding with the beginning of the COVID-19 pandemic. The number of KD cases (n=66) between April and December 2020 was 40% of the average in the same period in 2016–2019 (165/year). Annual KD incidence was 315, 300, 353, 347 and 188/100 000 children aged 0–4 years in 2016–2020, respectively. The difference-in-difference value of KD incidence was significantly reduced in the fourth quarter in 2020 (−15.8, 95% CI −28.0 to −3.5), compared with that in 2016–2019. Sentinel surveillance showed a marked decrease of all infectious diseases except exanthema subitum after the beginning of the COVID-19 pandemic. There were 86 COVID-19 cases aged <10 years and no KD children associated with COVID-19.ConclusionThis study showed that the number and incidence of KD was dramatically reduced during the COVID-19 pandemic in Japan. This change was temporally associated with decreased activities of various infectious diseases other than COVID-19, supporting the hypothesis of infection-triggered pathogenesis in KD.

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Pericardial Effusion Is Associated with Longer Length Of Stay And Higher Risk Of Readmission In Children With Kawasaki Disease: A Multicenter Retrospective Cohort Study From The Pediatric Health Information System (PHIS)

10.1542/peds.147.3_meetingabstract.391 ◽

2021 ◽

Author(s):

Amy Schexnayder ◽

Xinyu Tang ◽

R. Thomas Collins ◽

Stephen Schexnayder ◽

Elijah H. Bolin

Keyword(s):

Information System ◽

Cohort Study ◽

Pericardial Effusion ◽

Kawasaki Disease ◽

Length Of Stay ◽

Health Information ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Health Information System ◽

Pediatric Health

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Pericardial Effusion in Children Admitted With Kawasaki Disease: A Multicenter Retrospective Cohort Study From the Pediatric Health Information System

Clinical Pediatrics ◽

10.1177/0009922820927021 ◽

2020 ◽

Vol 60 (1) ◽

pp. 9-15

Author(s):

Amy G. Schexnayder ◽

Xinyu Tang ◽

R. Thomas Collins ◽

Stephen M. Schexnayder ◽

Elijah Holbrook Bolin

Keyword(s):

Information System ◽

Cohort Study ◽

Pericardial Effusion ◽

Kawasaki Disease ◽

Length Of Stay ◽

Health Information ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Health Information System ◽

Black Children

Pericardial effusion (PCE) can be associated with Kawasaki disease (KD). We performed a multicenter, retrospective cohort study of the Pediatric Health Information System of children admitted with KD to determine the association between PCE and adverse outcomes. A total of 17 422 patients were in the cohort, of which 440 (3%) had PCE. PCE was associated with longer hospital length of stay (adjusted odds ratio [aOR] = 1.23; P < .01) and risk of readmission at 30 days (aOR = 1.42; P = .03). Black children were more likely to have a PCE (aOR = 1.54, P < .01) and longer length of stay (aOR = 1.05; P < .001). These data may support delayed discharge in children with PCE and KD in the hopes of preventing readmission. Special consideration needs to be given to how black children with KD are managed.

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Development of coronary artery lesions in indolent kawasaki disease following initial spontaneous defervescence: a retrospective cohort study

Pediatric Rheumatology ◽

10.1186/s12969-015-0042-8 ◽

2015 ◽

Vol 13 (1) ◽

Cited By ~ 9

Author(s):

Takuto Takahashi ◽

Hiroshi Sakakibara ◽

Yoshihiko Morikawa ◽

Masaru Miura

Keyword(s):

Cohort Study ◽

Coronary Artery ◽

Kawasaki Disease ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Coronary Artery Lesions

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Kawasaki Disease May Increase the Risk of Subsequent Cerebrovascular Disease

Stroke ◽

10.1161/strokeaha.120.032953 ◽

2021 ◽

Author(s):

Chien-Heng Lin ◽

Jung-Nien Lai ◽

Inn-Chi Lee ◽

I-Ching Chou ◽

Wei-De Lin ◽

...

Keyword(s):

Cohort Study ◽

Kawasaki Disease ◽

Cerebrovascular Disease ◽

Incidence Rate ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Disease Incidence ◽

Hazard Ratio ◽

Adjusted Hazard Ratio ◽

Research Database

Background and Purpose: Previous epidemiological investigations examining the association between Kawasaki disease (KD) and cerebrovascular disease have had conflicting results. We analyzed the association between KD and cerebrovascular disease by conducting a population-based retrospective cohort study designed to investigate the hypothesis that KD could be a risk factor for subsequent cerebrovascular disease. Methods: From the National Health Insurance Research Database of Taiwan, the data of children (aged 0–18 years old) with KD (n=8467) were collected. Starting with the first year of study observation (referred to as the baseline year), data was collected for each child with KD, and 4 non-KD patients matched for sex, urbanization level of residence, and parental occupation were randomly selected to form the non-KD cohort (n=33 868) for our analysis. For the period from January 1, 2000, to December 31, 2012, we calculated the follow-up person-years for each patient, which is the time from the index date to the diagnosis of cerebrovascular disease, death, or the end of 2012. Furthermore, we compared the incidence, the incidence rate ratio, and the 95% CI of cerebrovascular disease between the KD and non-KD cohorts. Results: The overall cerebrovascular disease incidence rate was found to be 3.19-fold higher, which is significantly higher, in the KD cohort than in the non-KD cohort (14.73 versus 4.62 per 100 000 person-years), and the overall risk of cerebrovascular disease remained higher in the KD cohort (adjusted hazard ratio, 3.16 [95% CI, 1.46–6.85]). Furthermore, children aged <5 years showed a significantly higher risk of subsequent cerebrovascular disease in the KD cohort (adjusted hazard ratio, 3.14 [95% CI, 1.43–6.92]). Conclusions: This nationwide retrospective cohort study shows that KD may increase the risk of subsequent cerebrovascular disease, especially in those with KD aged <5 years old.

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