Stable Kawasaki disease incidence during COVID-19 quarantine
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Despite COVID-19 quarantine measures, Kawasaki disease incidence was unchanged in Japan compared with significant declines in respiratory tract and gastrointestinal infections, indicating airborne rather than contact or droplet transmission.

The development of Kawasaki disease (KD) has been suggested to be associated with droplet- or contact-transmitted infection; however, its triggers and transmission modes remain to be determined. Under an epidemic of SARS-CoV-2, the COVID-19 state of emergency in Japan served as a nationwide social experiment to investigate the impact of quarantine or isolation on the incidence of KD.

This study aimed to assess the role of droplet or contact transmission in the etiopathogenesis of KD. This multicenter, longitudinal, cross-sectional study was conducted at Fukuoka Children’s Hospital and 5 adjacent general hospitals. The number of admissions for KD and infectious diseases were analyzed. Participants were pediatric patients admitted to the participating hospitals for KD or infectious diseases.

Results:
-- The study participants included 1649 patients with KD (median age, 25 months; 901 boys) and 15586 patients with infectious disease.

-- The number of admissions for KD showed no significant change between April and May in 2015 to 2019 vs the same months in 2020.

-- However, the number of admissions for droplet-transmitted or contact-transmitted respiratory tract infection and gastrointestinal infections showed significant decreases between April and May in 2015 to 2019 vs the same months in 2020.

-- Thus, the ratio of KD to droplet- or contact-transmitted respiratory tract and gastrointestinal infections incidence in April and May 2020 was significantly increased.

Conclusively, in this study, the significantly increased incidence of KD compared with respiratory tract and gastrointestinal infections during the COVID-19 state of emergency suggests that contact or droplet transmission is not a major route for KD development and that KD may be associated with airborne infections in most cases.

Source: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2778178
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