Front Pediatr. 2026 Jul 15;14:1871138. doi: 10.3389/fped.2026.1871138. eCollection 2026.
ABSTRACT
BACKGROUND: The COVID-19 pandemic has been associated with changes in the epidemiology and clinical presentation of pediatric inflammatory diseases, including Kawasaki disease (KD). However, data comparing Kawasaki disease characteristics across pre-pandemic, pandemic, and post-pandemic periods remain limited.
METHODS: This retrospective single-center study included children diagnosed with KD between January 2015 and February 2024. Patients were classified as pre-pandemic (2015-2019), pandemic (2020-2021), or post-pandemic (2022-2024). Demographic characteristics, clinical features, laboratory findings, treatment response, and echocardiographic outcomes were compared among periods.
RESULTS: Eighty-seven patients were analyzed (pre-pandemic n = 46, pandemic n = 22, post-pandemic n = 19). During the pandemic period, C-reactive protein and erythrocyte sedimentation rate were significantly higher, thrombocytosis was more frequent, and cervical lymphadenopathy was less common. In the post-pandemic period, time to diagnosis was shorter, the number of clinical findings at presentation was higher, and elevations in liver transaminases were more frequent. Rates of intravenous immunoglobulin resistance, length of hospital stay, coronary artery involvement, and valvular regurgitation were similar across periods.
CONCLUSION: The COVID-19 pandemic was associated with changes in the inflammatory and clinical expression of Kawasaki disease without clear differences in cardiac outcomes, suggesting a greater effect on disease phenotype than on overall disease course; however, these findings should be interpreted in the context of the retrospective design and limited sample size.
PMID:42529301 | PMC:PMC13416352 | DOI:10.3389/fped.2026.1871138