Kawasaki disease incidence curbed by COVID-19 lockdown behaviors

Disclosures:
The authors report grants and consulting relationships with Biofire Diagnostics, DiaSorin Molecular, Karius, and Pfizer. Burney does not report any relevant financial information.

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According to data published in JAMA network open.

“Public health measures implemented during the COVID-19 pandemic have had widespread effects on population behaviors, transmission of infectious diseases, and exposures to environmental pollutants,” Jennifer A. Burney, Ph.D., from the School of Global Policy and Strategy at the University of California, San Diego, and the co-authors wrote. “This provided an opportunity to investigate how these factors potentially influenced the incidence of Kawasaki disease (KD), a self-limited pediatric vasculitis of unknown etiology.”

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To investigate the impact of the COVID-19 pandemic on KD, Burney and colleagues conducted a multicenter study with patients diagnosed between January 1, 2018 and December 31, 2020. All patients from 28 pediatric centers who met the American Heart Association Criteria for “complete or incomplete” KD were included in the analysis. Date of illness onset was defined as the first day the patient had a fever and was reported monthly for all patients, the authors wrote. Data such as age at disease onset, patient-reported race and ethnicity, GPS location of patients’ homes, and clinical assessment details were prospectively recorded.

The researchers used data provided by Safegraph, along with publicly available cellphone data regarding public health orders, to analyze the mobility patterns of Southern California residents between January 2019 and April 2021. The data was quantified the time residents spent away from home and allowed researchers to assess whether neighborhoods with KD were sheltering in place more or less effectively. Additionally, pollution data from January 2019 to October 2021 and common virus circulation patterns were analyzed.

A total of 2,461 cases of patients with KD were enrolled in the multicenter study, in addition to 1,461 cases from Rady Children’s Hospital San Diego (RCHSD) from 2002 to 2021. There was a national reduction of 28 .2% of KD cases in 2020 compared to 2018 and 2019, but the difference varied across the United States, the authors wrote. Additionally, mobility data did not appear to impact the overall KD count. Declining KD rates appeared to correlate with school closures, mask mandates, lower transmission of respiratory viruses and lower pollution levels. In San Diego, the number of KD cases rebounded in 2021, suggesting a correlation with the end of mask mandates in the region, the authors wrote.

“In this study of the incidence of KD in the United States between 2018 and 2020, the national and local (San Diego area) reduction in KD cases was associated with a period of school closures, masking, reduction of ambient pollution and reduction of the circulation of respiratory viruses. , all of which overlapped to varying degrees with the period of declining KD cases,” Burney wrote. “The observations presented here suggest several productive avenues for research into the etiology of KD.”

The authors added: “The pandemic has shown that limiting exposures to aerosols and large droplets through a combination of masking, social distancing and hand hygiene can reduce the incidence of KD in various communities across the world.”

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