J Korean Med Sci.  2022 May;37(20):e141. 10.3346/jkms.2022.37.e141.

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

• Kim BJ
• Choi A
• Kim HS
• Oh JH
• Lee JY
• Kim S
• Han JW
• Kim K
• Kim HH

• KMID: 2530103
• DOI: http://doi.org/10.3346/jkms.2022.37.e141

Abstract

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.

Keyword

Kawasaki Disease; Coronavirus Disease 2019; Complications; Children

Figure

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  Fig. 1 Flowchart of the study population.ICD-10 = International Classification of Diseases, 10th Revision, IVIG = intravenous immunoglobulin.

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  Fig. 2 Segmented regression analysis of the number of patients with KD. Compared with that in Mar 2018–Feb 2020 (A), the number of patients with KD per month in Mar 2020–Feb 2021 (B) has significantly decreased by 7.9 persons/month (95% CI, −13.8 to −2.0; P < 0.05). During the periods of 2018–2020 (A) and 2020–2021 (B), there was a decreasing trend in the number of admissions, but this trend was not statistically significant.KD = Kawasaki disease, CI = confidence interval, COVID-19 = coronavirus disease 2019.

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