Work

Epidemiologic trends of Kawasaki Disease and the potential impact of COVID-19 pandemic in Shanghai from 2018 through 2022

Year: 2025

Type: article

Abstract: BACKGROUND: Since 1998, the Shanghai Kawasaki Disease Research Group has systematically conducted four epidemiological surveys on Kawasaki disease (KD) once every 5 years. This study aimed to to analyze the epidemiological trends of KD and the potential impacts of the COVID-19 pandemic in Shanghai from 2018 through 2022. METHODS: Medical records of patients with KD diagnosed from January 2018 through December 2022 were retrospectively analyzed. Data were based on the Shenkang Kawasaki Disease Specific Database established by Shanghai Shenkang Hospital Development Center. Additional data were collected through questionnaires distributed to 48 hospitals providing pediatric medical care via the Shanghai Kawasaki Disease Research Group Network. The primary outcomes were the number and incidence of children with KD. The secondary outcomes included clinical features and changes observed during the COVID-19 pandemic. RESULTS: A total of 5791 cases were enrolled including 3549 permanent residents of Shanghai. The incidence of KD was 61.07 to 94.84 per 100,000 children aged <5 years from 2018 to 2022, with an average annual incidence of 80.7 per 100,000. The incidence decreased compared to the last survey (94.7 per 100,000), with pronounced declines in 2020 (62.74 per 100,000) and 2022 (61.07 per 100,000), which coincided with the implementation of COVID-19 containment measures. The male-to-female ratio was 1.58:1.00. The median age at onset was 25.3 months (interquartile range:14.1, 46.1 months). Of the 3654 cases with treatment information, 3310 were treated with intravenous immunoglobulin (IVIG), of which 317 (9.58%) were IVIG non-response. Out of the 4099 echocardiogram reports, 553 (13.49%) developed coronary artery lesions, and 191 (4.87%) had medium to large coronary artery aneurysms. No deaths were reported in this survey. CONCLUSIONS: The incidence of KD in Shanghai showed a downward trend during 2018-2022 compared to 2013-2017. The containment measures implemented during the COVID-19 pandemic, such as citywide suspension of work and school closures, may have affected the incidence of KD.

Source: Chinese Medical Journal

DOI: 10.1097/cm9.0000000000003901