RESUMEN
Kawasaki disease (KD) is a systemic vasculitis that occurs mainly in children under 5 years of age and is often accompanied by coronary artery lesions. The cause of the disease remains undetermined, but it is estimated to result from viral or bacterial infections. Certain studies have shown infection as a leading cause of KD. The purpose of this study was to investigate the relationship between KD incidence and viral infections in different pediatric age groups, using the Health Insurance Review and Assessment (HIRA) Open Access Big Data Platform, to confirm seasonal trends by analyzing monthly patterns. We investigated the HIRA data of KD patients (M30.3) who were treated with intravenous immunoglobulin from 2015 to 2018. Weekly virus positive detection rate data (PDR) for this period was obtained from the Korea Disease Control and Prevention Agency for human adenovirus (HAdV), human parainfluenza virus (HPIV), human respiratory syncytial virus (HRSV), influenza virus (IFV), human coronavirus (HCoV), human rhinovirus (HRV), human bocavirus (HBoV), human metapneumovirus (HMPV), rotavirus, norovirus, and astrovirus. We then analyzed the weekly/monthly virus PDR and its association with KD incidence, including monthly incidence patterns, and seasonal trends. Seasonal trend analysis of the virus PDR was performed using the time series analysis method through ARIMA (Autoregressive Integrated Moving Average). Correlations between KD incidence and PDR at 1- and 2-month intervals were analyzed using the Granger test. A total of 16,740 patients were diagnosed with KD during the study period, mainly young children, with a male-to-female ratio of 1.35. Specifically, 15,635 (93%) patients were under 5 years of age, with an incidence rate of 172.4/100,000 person-years. Annually, the cumulative number of cases per month was the highest in January, with an average of 469 cases, and was the lowest in September, with an average of 291 cases, although most were diagnosed with KD in winter (29.3%). Granger tests showed that PDR for HRSV, rotavirus, and norovirus were related with KD incidence by 1 month, while PDR for HRSV, HRV, rotavirus, and norovirus by 2 months. This study found that detection rates of respiratory and enteric viruses preceded KD by 1-2 months. Further research is needed to confirm the association between these viruses and KD.
RESUMEN
Immune thrombocytopenic purpura (ITP) is prevalent in children aged 2-5 years but may occur in all pediatric age groups. In 50-60% of pediatric patients, ITP is preceded by an upper respiratory tract infection 1-4 weeks before its onset. In this study, the relationship between the development of ITP and viral infections in children was assessed. We analyzed data of 6487 patients aged < 18 years with incident ITP from the Health Insurance Review and Assessment Open Access Big Data Platform (2015 to 2018) and the Korea Disease Control and Prevention Agency. The monthly positive detection rate (PDR) of seven respiratory and four acute diarrhea viruses was calculated. The virus PDR seasonal trend data was analyzed through ARIMA modeling. The ITP diagnostic data and prevalence of viral infection 1 and 2 months prior were analyzed using the Granger test. The overall male to female (M/F) ratio was 1.2, whereas it was 1.4 in the youngest age group (< 1 year). The overall ITP incidence rate was 18.1 per 100,000 person-years. Respiratory syncytial virus, rhinovirus, rotavirus, and astrovirus infections influenced ITP occurrence in children. However, rotavirus infection is positively associated with the etiology of ITP after 1-2 months.
