ĐẶC ĐIỂM DỊCH TỄ, LÂM SÀNG, CẬN LÂM SÀNG VÀ BIẾN CHỨNG TIM MẠCH Ở TRẺ EM MẮC BỆNH KAWASAKI TẠI BỆNH VIỆN NHI ĐỒNG 1 TRƯỚC, TRONG VÀ SAU ĐẠI DỊCH COVID-19

Abstract

Objective. To Determine and compare the proportions and mean values of clinical features, laboratory findings, and admission treatments in patients with Kawasaki disease (KD), as well as the prevalence of coronary artery lesions at admission, 2–8 weeks, and 6–12 months after disease onset across the pre–COVID-19, COVID-19, and post-pandemic endemic periods..

Methods. A retrospective descriptive case series including 412 patients aged 0–16 years diagnosed with Kawasaki disease and Kawasaki-like multisystem inflammatory syndrome in children (MIS-C), hospitalized at Children’s Hospital 1 between 01/2019 and 12/ 2023.

Results. Among 412 analyzed cases (90 pre-pandemic, 122 during the pandemic, and 200 in the “new normal” period), the median age increased from 17.5 months pre-pandemic to 23.5 months post-pandemic, while the proportion of children ≥60 months rose from 7.8% to 20.5% (p = 0.002). There were no statistically significant differences in sex distribution or the proportion of incomplete Kawasaki disease across periods. Laboratory findings showed higher rates of hyponatremia (82.6% vs. ~50% previously, p<0.001) and thrombocytopenia (11.3%, p=0.03). Initial corticosteroid use, particularly methylprednisolone, increased post-pandemic (0% to 31.7%, p<0.001). Coronary artery involvement at admission increased across the three periods, although the difference was not statistically significant.

Conclusion. Post–COVID-19, the age at onset was higher, with an increased proportion of children ≥5 years. The male-to-female disparity decreased, while the rate of incomplete Kawasaki disease rose notably during the post-pandemic period.