Decreased risk of hospitalization for respiratory tract infection in children with Kawasaki disease: a nationwide population-based matched cohort study


Abstract

Background: Kawasaki disease (KD) is an immune-mediated systemic vasculitis and infection plays an important role in the pathophysiology of KD. The susceptibility to infectious disease in patients with KD remains largely unclear. This study aimed to investigate the risk of respiratory tract infection (RTI)-related hospitalizations in children with KD.

Methods: Data from Taiwanese National Health Insurance Research Database was analyzed. Children with KD were selected as KD group and age- and sex-matched non-KD patients were selected as control group with 1:1 ratio. Both cohorts were tracked for 1 year to investigate the incidences of RTI-related hospitalizations. Cox regression hazard model was used to adjust for confounding factors and calculate the adjusted hazard ratio (aHR).

Results: Between January 1996 and December 2012, 13,760 patients with KD were identified as KD group and 13,709 patients were enrolled as control group. An obviously reduced risk of RTI-related hospitalizations was observed in KD patients (aHR: 0.53, 95% confidence interval: 0.49-0.57). The decreased risk persisted through the 1-year follow-up period with a peak protection in 3-6 months (aHR: 0.46, 95% confidence interval: 0.40-0.53).

Conclusions: KD patients had approximately half reduction of risk for RTI-related hospitalizations. The protective effects persisted for at least 1 year. Further studies are warranted to elucidate the entire mechanism and investigate the influences of intravenous immunoglobulin.

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