Comparison of Previous Infectious and Allergic Diseases Between Patients with Kawasaki Disease and Propensity Score-matched Controls: A Nationwide Cohort Study

Abstract

Objective: To determine whether previous infectious and allergic diseases are associated with the development of Kawasaki disease in children.

Study design: This nationwide, population-based, case-control study used data from the Korean National Health Insurance claims database. The entire cohort consisted of patients younger than 5 years of age diagnosed with Kawasaki disease and 1:5 propensity score-matched controls from 2013 to 2019. The epidemiologic features and previous infectious or allergic diseases between the 2 groups were compared, and potential factors that could influence the association were identified.

Results: In total, 32 964 patients diagnosed with Kawasaki disease and 164 820 controls were included. Patients with Kawasaki disease had more frequent diagnoses of previous sepsis or bacteremia (OR 1.41), acute pyelonephritis (OR 1.10), and otitis media (OR 1.24). In addition, Kawasaki disease was associated with previous diagnoses of atopic dermatitis (OR 1.05), urticaria (OR 1.08), and asthma (OR 1.05). The association between previous infectious or allergic diagnoses and Kawasaki disease was more prominent in younger patients (<2 years). However, intravenous immunoglobulin resistance, sex, and region of residence were not significant factors that consistently influenced the association between previous infectious or allergic diseases and Kawasaki disease.

Conclusions: Despite the increased rates of previous infectious and allergic diseases in patients with Kawasaki disease compared with controls, the association between allergic diseases and Kawasaki disease was weaker in our cohort than in previous studies.

Keywords: asthma; atopic dermatitis; infection; pyelonephritis; sepsis; urticaria.