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. 2021 Jul 23;8(8):623.
doi: 10.3390/children8080623.

Public Health Interventions for COVID-19 Reduce Kawasaki Disease in Taiwan

Ya-Ling Yang  1 , Ho-Chang Kuo  2   3   4
Affiliations

Public Health Interventions for COVID-19 Reduce Kawasaki Disease in Taiwan

Ya-Ling Yang et al. Children (Basel). .

Abstract

Background: Kawasaki disease (KD) is a syndrome of unknown cause that results in high fever and coronary vasculitis in children. The incidence of KD increased in Taiwan over the past few decades. Taiwanese government executed domains of early screening, effective methods for isolation or quarantine, and digital technologies for identifying potential cases for the early elimination strategy for coronavirus disease 2019 (COVID-19) and public health interventions for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or COVID-19 pandemic, leading to an effective reduction of the risk of airway infections in children. The purpose of this study is to analyze whether those public health interventions reduce the incidence of KD in 2020.

Methods: Patients with KD who visited Chang Gung Memorial Hospital (CGMH) between 1 January, 2018, and 31 December, 2020 were included for trend analysis. This is a retrospective case series study conducted at the CGMH, which consists of a network of seven hospital branches equipped with more than 10,000 beds in different areas of Taiwan.

Results: Compared with the 2018 and 2019 databases, the incidence of KD decreased significantly by 30% and 31%, respectively (p < 0.05) in 2020, when public health interventions were comprehensively implemented in Taiwan. This result shows that the incidence of KD decreased during the COVID-19 pandemic in Taiwan without change of the presentation KD (typical or incomplete) and percentage of IVIG resistance in 2020.

Conclusion: As public health interventions were carried out for the SARS-CoV-2 pandemic, the incidence of KD was significantly reduced in Taiwan. Is KD a preventable disease?

Keywords: COVID-19; Kawasaki disease; SARS-CoV-2; public health interventions.

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Conflict of interest statement

All the authors hereby declare to have no financial interest to disclose with regard to this article.

Figures

Figure 1
Figure 1
(A) Timeline for COVID-19 cases in Taiwan before 1 April. (B) Comparison of the average monthly numbers of KD cases in Chang Gung Memorial Hospital (CGMH) from 2018 to 2020. The CGMH consists of a network of seven hospital branches, with a total of 10,050 beds, and provides Taiwan’s largest and most comprehensive healthcare services. Compared with 2018 and 2019, there was no significant difference in KD cases in the first quarter of 2020 (p = 0.267 and 0.334, respectively), but the number of KD patients decreased significantly from April to September in 2020. All data are expressed as mean ± standard error. We used one-way analysis of variance with least significant (LSD) test for post-hoc testing to evaluate quantitative data. * Indicates p < 0.05, ** p < 0.01, *** p < 0.001.
See this image and copyright information in PMC

References

    1. Wang C.L., Wu Y.T., Liu C.A., Kuo H.C., Yang K.D. Kawasaki disease: Infection, immunity and genetics. Pediatr. Infect. Dis. J. 2005;24:998–1004. doi: 10.1097/01.inf.0000183786.70519.fa. - DOI - PubMed
    1. Huang Y.H., Lin K.M., Ho S.C., Yan J.H., Lo M.H., Kuo H.C. Increased Incidence of Kawasaki Disease in Taiwan in Recent Years: A 15 Years Nationwide Population-Based Cohort Study. Front. Pediatr. 2019;7:121. doi: 10.3389/fped.2019.00121. - DOI - PMC - PubMed
    1. Rowley A.H., Shulman S.T. The Epidemiology and Pathogenesis of Kawasaki Disease. Front. Pediatr. 2018;6:374. doi: 10.3389/fped.2018.00374. - DOI - PMC - PubMed
    1. Huang Y.H., Li S.C., Huang L.H., Chen P.C., Lin Y.Y., Lin C.C., Kuo H.C. Identifying genetic hypomethylation and upregulation of Toll-like receptors in Kawasaki disease. Oncotarget. 2017;8:11249–11258. doi: 10.18632/oncotarget.14497. - DOI - PMC - PubMed
    1. Zhu N., Zhang D., Wang W., Li X., Yang B., Song J., Zhao X., Huang B., Shi W., Lu R., et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N. Engl. J. Med. 2020;382:727–733. doi: 10.1056/NEJMoa2001017. - DOI - PMC - PubMed