Risks of Kawasaki disease and multisystem inflammatory syndrome in pediatric patients with COVID-19 infection: A TriNetX based cohort study.

Autor:	Chien KJ; Congenital Structural Heart Disease Center, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC., Wei CJ; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, ROC.; Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan, ROC.; Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan, ROC.; Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan, ROC., Huang SH; Department of Nursing, Fooyin University, Kaohsiung, Taiwan, ROC., Chen CY; Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan, ROC., Kuo HC; Department of Pediatrics, Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan, ROC., Hung YM; Division of Nephrology, Department of Internal Medicine, Taipei Veterans General Hospital Taitung Branch, Taitung, Taiwan, ROC., Liao PL; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, ROC.; Center for Health Data Science, Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan, ROC., Huang JY; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, ROC.; Center for Health Data Science, Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan, ROC., Cheng MF; Congenital Structural Heart Disease Center, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC., Weng KP; Congenital Structural Heart Disease Center, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC.; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
Jazyk:	angličtina
Zdroj:	Journal of the Chinese Medical Association : JCMA [J Chin Med Assoc] 2024 Sep 01; Vol. 87 (9), pp. 861-869. Date of Electronic Publication: 2024 Jul 16.
DOI:	10.1097/JCMA.0000000000001137
Abstrakt:	Background: The associations of coronavirus disease (COVID-19) with Kawasaki disease (KD) and multisystem inflammatory syndrome in children (MIS-C) remain unclear. Few large-scale studies have estimated the cumulative incidence of MIS-C and KD after COVID-19 in children. Methods: Data were obtained from TriNetX. After propensity score matching was completed, data from 258 645 patients with COVID-19 (COVID-19 group) and 258 645 patients without COVID-19 (non-COVID-19 group) were analyzed using Cox regression. Hazard ratio (HR), 95% CI, and cumulative incidence of MIS-C and KD were calculated for both groups. A stratified analysis was performed to validate the results. Results: After matching for age at baseline and sex, the risks of MIS-C and KD were higher in the COVID-19 group than in the non-COVID-19 group (HR: 3.023 [95% CI, 2.323-3.933] and 1.736 [95% CI, 1.273-2.369], respectively). After matching for age at baseline, sex, race, ethnicity, and comorbidities, the risks of MIS-C and KD remained significantly higher in the COVID-19 group than in the non-COVID-19 group (HR: 2.899 [95% CI, 2.173-3.868] and 1.435 [95% CI, 1.030-2.000]). When stratified by age, the risk of MIS-C was higher in the COVID-19 group-for patients aged >5 years and ≤5 years (HR: 2.399 [95% CI, 1.683-3.418] and 2.673 [95% CI, 1.737-4.112], respectively)-than in the non-COVID-19 group. However, the risk of KD was elevated only in patients aged ≤5 years (HR: 1.808; 95% CI, 1.203-2.716). When stratified by COVID-19 vaccination status, the risks of MIS-C and KD were elevated in unvaccinated patients with COVID-19 (HR: 2.406 and 1.835, respectively). Conclusion: Patients with COVID-19 who are aged <18 and ≤5 years have increased risks of MIS-C and KD, respectively. Further studies are required to confirm the role of COVID-19 in the pathogenesis of MIS-C and KD. Competing Interests: Conflicts of interest: The authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article. (Copyright © 2024, the Chinese Medical Association.)
Databáze:	MEDLINE
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