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Prevention Measures for COVID-19 and Changes in Kawasaki Disease Incidence.

ABSTRACT: Kawasaki disease is suspected to be triggered by previous infection. The prevention measures for coronavirus disease 2019 (COVID-19) have reportedly reduced transmission of certain infectious diseases. Under these circumstances, the prevention measures for COVID-19 may reduce the incidence of Kawasaki disease. We conducted a retrospective study using registration datasets of patients with Kawasaki disease who were diagnosed in all 11 inpatient pediatric facilities in Yamanashi Prefecture. The eligible cases were 595 cases that were diagnosed before the COVID-19 pandemic (from January 2015 through February 2020) and 38 cases that were diagnosed during the COVID-19 pandemic (from March through November 2020). Incidence of several infectious disease were evaluated using data from the Infectious Disease Weekly Report conducted by the National Institute of Infectious Diseases. Epidemics of various infectious diseases generally remained at low levels during the first 9 months (March through November 2020) of the COVID-19 pandemic. Moreover, the incidence of COVID-19 was 50-80 times lower than the incidence in European countries and the United States. The total number of 38 cases with Kawasaki disease for the 9 months during the COVID-19 pandemic was 46.3% (-3.5 standard deviations [SDs] of the average [82.0; SD, 12.7 cases] for the corresponding 9 months of the previous 5 years. None of the 38 cases was determined to be triggered by COVID-19 based on their medical histories and negative results of severe acute respiratory syndrome coronavirus 2 testing at admission. These observations provide a new epidemiological evidence for the notion that Kawasaki disease is triggered by major infectious diseases in children.

SUBMITTER: Katsumata N

PROVIDER: S-EPMC8502831 | biostudies-literature | 2021 Nov

REPOSITORIES: biostudies-literature

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Prevention Measures for COVID-19 and Changes in Kawasaki Disease Incidence.

Katsumata Nobuyuki N Harama Daisuke D Toda Takako T Sunaga Yuto Y Yoshizawa Masashi M Kono Yosuke Y Hasebe Yohei Y Koizumi Keiichi K Hoshiai Minako M Saito Tomohiro T Hokibara Sho S Kobayashi Koji K Goto Miwa M Sano Tomoaki T Tsuruta Makoto M Nakamura Makoto M Mizorogi Sonoko S Ohta Masanori M Mochizuki Mie M Sato Hiroki H Yokomichi Hiroshi H Inukai Takeshi T

Journal of epidemiology 20210917 11

<h4>Background</h4>Kawasaki disease is suspected to be triggered by previous infection. The prevention measures for coronavirus disease 2019 (COVID-19) have reportedly reduced transmission of certain infectious diseases. Under these circumstances, the prevention measures for COVID-19 may reduce the incidence of Kawasaki disease.<h4>Methods</h4>We conducted a retrospective study using registration datasets of patients with Kawasaki disease who were diagnosed in all 11 inpatient pediatric faciliti ...[more]

PMID: 34483151

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Project description:Aim: The aim of this study was to analyze the changes in incidence of notifiable infectious diseases in China under the prevention and control measures of COVID-19. Methods: Using descriptive epidemiological methods, data were collected from the official website of the Health Commission of the People's Republic of China, and the prevalence characteristics of notifiable infectious diseases in the country in 2020 were analyzed and compared with the historical data in 2019. Monthly reporting data on influenza and tuberculosis from 2015 to 2019 were also collected. Results: Except for COVID-19, the total number of notifiable infectious diseases cases in 2020 was 6,366,176, a decrease of 41.38% year-on-year compared with 2019. Category B and C notifiable infectious diseases decreased by 14.84 and 54.98% year-on-year, respectively (P < 0.01). The top three incidence rates were influenza (87.63 cases/100,000), hepatitis B (81.36 cases/100,000) and other infectious diarrhea (76.33 cases/100,000). Three types of diseases with the largest decline were influenza (-2,280,502 cases), hand-foot-mouth disease (-1,174,588 cases), and other infectious diarrhea diseases (-275,746 cases). Compared with 2019, respiratory infectious diseases were reported to be in the largest decline in 2020, followed by intestinal infectious diseases, blood-borne and sexually transmitted diseases, natural foci, and insect-borne infectious diseases. The monthly reported incidences of influenza and tuberculosis in 2020 were lower than the average of the previous 5 years. Conclusion: In 2020, the incidence of most notifiable infectious diseases in China showed a downward trend, non-pharmaceutical interventions (NPIs)such as the wearing of masks, frequent hand-washing, more ventilation, less gathering, etc, played an positive role in the prevention and control of respiratory and intestinal infectious diseases. The various public health intervention strategies and measures adopted by China to contain COVID-19 can provide a reference for the prevention and control of infectious diseases in other countries.

Project description:BackgroundEpidemiological studies in Kawasaki disease (KD) have suggested infectious aetiology. During the COVID-19 pandemic, measures for mitigating SARS-CoV-2 transmission also suppress the circulation of other contagious microorganisms. The primary objective is to compare the number and incidence of KD before and during the COVID-19 pandemic in Japan, and the secondary objective is to investigate temporal association between the KD epidemiology and activities of SARS-CoV-2 and other viral and bacterial infections.MethodsA retrospective cohort study was conducted between 2016 and 2020 in Kobe, Japan. We collected information of hospitalised KD children in Kobe. Child population was identified through the resident registry system. Activity of COVID-19 and 11 other infectious diseases was derived from a public health monitoring system. Monthly change of KD incidence was analysed using a difference-in-difference regression model.ResultsThroughout the study period, 1027 KD children were identified. KD had begun to decline in April 2020, coinciding with the beginning of the COVID-19 pandemic. The number of KD cases (n=66) between April and December 2020 was 40% of the average in the same period in 2016-2019 (165/year). Annual KD incidence was 315, 300, 353, 347 and 188/100 000 children aged 0-4 years in 2016-2020, respectively. The difference-in-difference value of KD incidence was significantly reduced in the fourth quarter in 2020 (-15.8, 95% CI -28.0 to -3.5), compared with that in 2016-2019. Sentinel surveillance showed a marked decrease of all infectious diseases except exanthema subitum after the beginning of the COVID-19 pandemic. There were 86 COVID-19 cases aged <10 years and no KD children associated with COVID-19.ConclusionThis study showed that the number and incidence of KD was dramatically reduced during the COVID-19 pandemic in Japan. This change was temporally associated with decreased activities of various infectious diseases other than COVID-19, supporting the hypothesis of infection-triggered pathogenesis in KD.

Project description:ImportanceGlobal studies have reported that the incidence of Kawasaki disease (KD) declined during the COVID-19 pandemic. These studies suggest that the global pandemic and its accompanying mitigation measures may provide an important opportunity to explore the hypothesis of a KD pathogenesis.ObjectiveTo compare changes in KD incidence in Japan before and after the start of the COVID-19 pandemic.Design, setting, and participantsThis cohort study was conducted using the data set from Japan's 26th nationwide KD survey that obtained information on patients who were diagnosed with KD in Japan from January 1, 2019, through December 31, 2020.Main outcomes and measuresKawasaki disease incidence rates were calculated by referring to the national population data in the vital statistics data for Japan.ResultsA total of 28 520 patients were identified (16 236 male individuals [56.9%]; median [IQR] age, 26 [14-44] months). A total of 17 347 patients were diagnosed with KD in 2019 and 11 173 were diagnosed in 2020, representing a 35.6% reduction in the number of patients diagnosed in 2020 compared with the previous year. Patient distributions for days of illness at the first hospital visit were almost identical in 2019 and 2020, suggesting that the decrease in KD incidence likely was not associated with pandemic-related delays in seeking treatment. The proportion of patients diagnosed with KD who were younger than 12 months was significantly larger in 2020 than in 2019 (21.6% vs 19.4%; P < .001). Compared with KD incidence among younger patients, the incidence among those 24 months and older declined rapidly after initiation of COVID-19 special mitigation measures, with a greater percentage reduction (58.3% reduction in July), but rebounded faster after the end of the special mitigation period. By contrast, the incidence among patients younger than 12 months declined moderately after the initiation of the special mitigation period, with a lower percentage reduction (40.3% reduction in October), and rebounded at a later phase.Conclusions and relevanceIn this cohort study, the number of patients diagnosed with KD decreased by approximately one-third across Japan in 2020, with no indication that parents avoided a hospital visit. Differences in KD incidence reduction patterns before and after the initiation of COVID-19 pandemic mitigation measures were found in patients with KD aged younger than 12 months compared with those 24 months or older, suggesting a potential KD pathogenesis involving transmission among children.

Dataset Information

Prevention Measures for COVID-19 and Changes in Kawasaki Disease Incidence.

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Prevention Measures for COVID-19 and Changes in Kawasaki Disease Incidence.

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