Risks of Kawasaki disease and multisystem inflammatory syndrome in pediatric patients with COVID-19 infection: A TriNetX based cohort study.
J Chin Med Assoc
; 87(9): 861-869, 2024 Sep 01.
Article
em En
| MEDLINE
| ID: mdl-39017646
ABSTRACT
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.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Síndrome de Resposta Inflamatória Sistêmica
/
COVID-19
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Síndrome de Linfonodos Mucocutâneos
Limite:
Adolescent
/
Child
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Child, preschool
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Female
/
Humans
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Infant
/
Male
País/Região como assunto:
Asia
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article