川崎病在 COVID-19 大流行前后的发病率：日本的一项回顾性队列研究。

Incidence of Kawasaki disease before and during the COVID-19 pandemic: a retrospective cohort study in Japan.

机构信息

Department of Pediatrics, Kobe City Nishi-Kobe Medical Center, Kobe, Hyogo, Japan.

Department of Pediatrics, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan.

出版信息

BMJ Paediatr Open. 2021 Apr 2;5(1):e001034. doi: 10.1136/bmjpo-2021-001034. eCollection 2021.

DOI:10.1136/bmjpo-2021-001034

PMID:33884312

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8023747/

Abstract

BACKGROUND

Epidemiological 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.

METHODS

A 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.

RESULTS

Throughout 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.

CONCLUSION

This 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.

摘要

背景

川崎病（KD）的流行病学研究表明其具有感染性病因。在 COVID-19 大流行期间，为减轻 SARS-CoV-2 传播而采取的措施也抑制了其他传染性微生物的传播。本研究的主要目的是比较日本 COVID-19 大流行前后 KD 的发病数量和发病率，次要目的是调查 KD 流行病学与 SARS-CoV-2 以及其他病毒和细菌感染活动之间的时间关联。

方法

本研究为 2016 年至 2020 年期间在日本神户进行的回顾性队列研究。我们收集了神户住院 KD 患儿的信息。通过居民登记系统确定儿童人群。从公共卫生监测系统中获取 COVID-19 和其他 11 种传染病的活动数据。采用差异中差异回归模型分析 KD 发病率的月度变化。

结果

在整个研究期间，共确定了 1027 例 KD 患儿。2020 年 4 月，KD 开始下降，恰逢 COVID-19 大流行开始。2020 年 4 月至 12 月期间，KD 病例数（n=66）为 2016-2019 年同期平均值（每年 165 例）的 40%。2016-2020 年，年龄 0-4 岁的儿童中，每年 KD 的发病率分别为 315、300、353、347 和 188/100000。与 2016-2019 年相比，2020 年第四季度 KD 发病率的差异值明显降低（-15.8，95%CI -28.0 至 -3.5）。哨点监测显示，COVID-19 大流行开始后，除幼儿急疹外，所有传染病的活动均明显减少。有 86 例年龄<10 岁的 COVID-19 病例，没有与 COVID-19 相关的 KD 患儿。