The relationship of enterovirus (EV) infection and Kawasaki disease (KD) is still unclear. The purpose of this study was to conduct a population-based cohort study to determine the relationship between KD and EV infection in Taiwan.
A population-based cohort study was conducted to analyze the children file (age < 18 years) of the Taiwan National Health Insurance program between 2000 and 2008. In total, 285,636 children with EV infection and 285,636 children without EV infection were included and followed up. The subsequent KD was the major outcome event.
The cumulative incidence of KD was significantly higher in the EV-infected cohort than in the non-EV–infected cohort (log-rank test, P < 0.001). The overall incidence of KD was 56% higher in the EV-infected cohort than in the non-EV–infected cohort, with an adjusted hazard ratio of 1.56 (95% confidence interval: 1.44–1.69). Stratified analysis showed higher KD risk associated with previous EV infection in children 3–5 years old, in girls, in children living in less urbanization levels, in children with parental low-income occupation, and in children with allergic diseases.
There is a higher association between KD and previous EV infection in Taiwanese children, especially in those 3–5 years old, with female sex, with less urbanization level, with low-income parental occupation, and with allergy.
From the *Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; †Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan; ‡Department of Physical Therapy, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan; §Division of Allergy, Immunology and Rheumatology, Department of Medicine, Chung Shan Medical University Hospital, ¶Institute of Medicine, Chung Shan Medical University, and ‖Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan; **Department of Emergency Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; ††Institute of Public Health, School of Medicine, National Yang Ming University, Taipei, Taiwan; ‡‡Yuhing Junior College of Health Care and Management, Kaohsiung, Taiwan; §§Department of Nursing, Fooyin University, Kaohsiung, Taiwan; ¶¶Department of Pediatrics, Kaohsiung Municipal United Hospital, Kaohsiung, Taiwan; and ‖‖Management Office for Health Data, China Medical University Hospital, and ***College of Medicine, China Medical University, Taichung, Taiwan.
Accepted for publication July 10, 2017.
The authors have no funding or conflicts of interest to disclose.
* K.-P.W. and J.C.-C.W. authors contributed equally to the work.
Address for correspondence: Ken-Pen Weng, MD, Department of Pediatrics, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Road, Kaohsiung 813, Taiwan. E-mail: email@example.com.