Social behavior related to the COVID-19 pandemic is: Kawasaki diseaseAccording to the results of a cohort study of nearly 4,000 children.
The incidence of Kawasaki disease in the United States decreased by 28.2% between 2018 and 2020. This is probably due to factors such as school closures, mandatory masks, and reduced ambient pollution that may reduce exposure to Kawasaki disease (KD) in the environment, but Jennifer A. of the University of California, San Diego. • According to Dr. Bernie et al., Potential relevance has not been investigated.
KD has received greater public and medical attention due to the emergence of pediatric multisystem inflammatory syndrome (MIS-C), which is similar to but different from KD, and the marked reduction in KD cases during a pandemic. rice field. The researcher said.
Overall, the prevalence of KD decreased across the United States from 894 in 2018 to 646 in 2020, but the decline was uneven, the researchers said.
In the RCHSD cohort of San Diego, KD cases in children aged 1 to 5 years decreased significantly from 2020 to 2021 compared to the average number of cases in the previous year (22 vs. 44.9,). P = .02). Cases of KD also decreased significantly between men and children in Asia.
In particular, in 2020, although only the strawberry tongue reached statistical significance, the development of KD clinical features of the strawberry tongue, cervical lymph node enlargement, and subacute periungual desquamation was compared to the baseline period. Decreased (39% vs. 63%, P = .04). The prevalence of patients with enlarged lymph nodes was 21% in 2020, compared to 32% before the pandemic (pre-pandemic).P = .09); The prevalence of desquamation around the nail during these periods was 47% vs. 58%. P = .16).
Researchers also used data from the Census Subgroup (CBG) to assess the impact of mobility metrics and environmental exposure on KD during a pandemic in a San Diego patient cohort. They found that KD cases during a pandemic were more likely to occur in areas with high socioeconomic status, and fewer KD cases in areas with low nitrous oxide levels.
Overall, “decreased KD cases were consistent with masking, school closures, reduced respiratory virus circulation, and reduced air pollution,” the researchers wrote in a discussion of the findings. “The recovery of KD cases to pre-pandemic levels coincided with the removal of mask obligations and the subsequent return to face-to-face education,” they wrote.
Researchers noted that the study results were limited by several factors, including a small sample size that also limited mobility and interpretation of contamination data. Other restrictions include high KD aging and only 2021 rebound data from the San Diego region.
“Our initial hypothesis was that shelter-in-place measures would reduce and track KD cases, but this was not supported by data from the San Diego region. Instead, San Diego case outbreaks. The data suggest that the shift to households with high SES during pandemics is likely to cause the exposure that caused KD in the household, “the researchers say. However, “the results presented here are consistent with the KD-triggered breathing portal,” they said.
Research fails to validate that conclusion
“This study seeks to test the hypothesis that various social restrictions are associated with a reduced diagnosis rate of Kawasaki disease in parts of the SARS-CoV-2 pandemic,” said Columbia University, New York. Assistant Professor of Pediatrics, Dr. Mark Gorelick of Medicine. York said in an interview.
“But it seems that this conclusion cannot be achieved and I disagree with the findings,” he said, although he was not involved in the study. Updated Kawasaki Disease Treatment Guidelines In the spring of this year Arthritis and rheumatology..
“In this study, as stated in the conclusion, there was no statistically significant association with shelter-in-place orders or mobile phone mobility data, which is in direct conflict with our claim.” Gorelick said. “Second, this study assumes that various methods, especially the wearing of masks by children and the closure of schools, have had a significant impact on the spread of the respiratory virus. Future population bases that test this claim. There is no controlled real-world study of, and there are two future controlled real-world studies that disagree with this, “he emphasized. “Cloth masks and surgical masks, which are the types of masks worn by school students, are also known to be insignificant and insignificant. The latter is certainly less than 50%, perhaps 10% effective. Affects reductions in the spread of respiratory viruses, “he added.
“Overall, we need solid evidence to support the benefits of the hypothesis that caused obvious damage to children during this pandemic (such as school closures), and this study does not meet that requirement,” Gorerick said. rice field.
This study was supported by the Gordon and Marilyn McClin Foundation and the Patient-Centered Outcomes Institute. Bernie and Gorelic had no economic conflict to disclose.
This story originally appeared MDedge.comIs part of the Medscape Professional Network.
