Department of Pediatrics, Shiga University of Medical Science, Shiga, Japan.
National Institute of Technology, Gifu College, Gifu, Japan.
J Pediatr. 2022 Nov;250:54-60.e5. doi: 10.1016/j.jpeds.2022.07.008. Epub 2022 Jul 16.
To assess regional differences in reduction of the incidence of Kawasaki disease during the mitigation period for the coronavirus disease 2019 pandemic, with a hypothesis that more sparsely populated regions have fewer opportunities for human-to-human contact, resulting in a greater reduction in the incidence of Kawasaki disease.
A retrospective ecological study was conducted using data from patients hospitalized for Kawasaki disease as well as infectious diseases surveillance reports in Shiga Prefecture, Japan, during 2015-2020. We defined the periods before and after the onset of pandemic as January 2015-March 2020 and as April 2020-December 2020, respectively. We compared the reductions in the incidence of Kawasaki disease among 6 administrative regions in the prefecture according to the density of the populations.
A total of 1290 patients with Kawasaki disease were identified. The incidence of Kawasaki disease (per 100 000 person-years) was significantly reduced after the coronavirus disease 2019 pandemic onset (period before pandemic onset, 105.6 [95% CI 99.8-111.8]; period after pandemic onset, 68.6 [95% CI 56.7-83.0]). During the period after pandemic onset, the incidence of Kawasaki disease was significantly reduced in May, compared with the corresponding period in previous years. The number of patients aged 2-4 years was significantly reduced after the pandemic onset. Notably, greater reductions in the incidence of Kawasaki disease were found in regions with lower population densities.
Assuming that there were fewer opportunities for human-to-human contact in more sparsely populated regions during the pandemic mitigation period, our findings support the hypothesis that human-to-human contact may be associated with development of Kawasaki disease.
评估 2019 年冠状病毒病大流行缓解期间川崎病发病率降低的区域差异，假设人口密度较低的地区人与人之间接触的机会较少，导致川崎病发病率降低幅度更大。
采用日本滋贺县川崎病住院患者及传染病监测报告数据进行回顾性生态学研究，将 2015 年至 2020 年期间分为大流行前（2015 年 1 月至 2020 年 3 月）和大流行后（2020 年 4 月至 2020 年 12 月）两个时期。根据人口密度比较该县 6 个行政区川崎病发病率的降低情况。
共纳入 1290 例川崎病患者。川崎病发病率（每 10 万人年）在冠状病毒病 2019 大流行后显著降低（大流行前时期为 105.6[95%CI 99.8-111.8]；大流行后时期为 68.6[95%CI 56.7-83.0]）。大流行后时期，5 月川崎病发病率较往年同期显著降低。发病年龄 2-4 岁患者人数在大流行后显著减少。值得注意的是，人口密度较低的地区川崎病发病率降低幅度更大。
假设大流行缓解期间人口密度较低的地区人与人之间接触的机会较少，我们的研究结果支持人与人之间接触可能与川崎病发病相关的假设。
