Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Jun 4, 2023
Date Accepted: Apr 5, 2024
Kawasaki Disease and Respiratory Viruses: An Ecological, Spatiotemporal Analysis
ABSTRACT
Background:
Background Kawasaki disease is an uncommon vasculitis affecting young children. While infections have been frequently postulated as the triggers, the etiology of Kawasaki disease remains poorly understood.
Objective:
We aimed to determine whether Kawasaki disease incidence was related to community respiratory virus circulation and to describe viral associations prior to and during the COVID-19 pandemic.
Methods:
We conducted a spatiotemporal ecological analysis of hospital admissions data in Victoria, Australia from July 2011 to November 2021. We obtained independent state-wide datasets of admitted episodes of Kawasaki disease and respiratory multiplex PCR tests of respiratory viruses performed at two large hospital networks in Victoria from July 2011- November 2021. We studied spatiotemporal patterns by negative binomial regression analysis of the monthly incidence of Kawasaki disease and the rate of positive PCR tests. Peak viral seasons (95th centile incidence) were compared to median viral circulation (50th centile incidence) to calculate peak season risk ratios.
Results:
We found a 1.52 (99%CI 1.27-1.82) and a 1.43 (99%CI 1.17-1.73) risk ratio of Kawasaki disease in association with human metapneumovirus and respiratory syncytial virus respectively before the COVID-19 pandemic, but no associations were observed during the COVID-19 pandemic. No clear seasonal trends of Kawasaki disease were identified.
Conclusions:
Our large ecological analysis demonstrates novel spatiotemporal associations between specific viral community circulation and Kawasaki disease. The potential roles of human metapneumovirus and RSV in Kawasaki disease etiology warrant further investigation. Clinical Trial: N/A
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