Impact of COVID-19 infection on Kawasaki disease and immune status in children

Abstract Patients infected with SARS-CoV-2 may experience acute and long-term immune disorders. Immunological factors are thought to play an important role in Kawasaki disease. To analyze the impact of COVID-19 infection on Kawasaki disease, this study retrospectively analyzed 161 children with Kawa...

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Main Authors: Lichao Gao, Zhufei Xu, Jian Hu, Qing Zhang, Songling Fu, Wei Wang, Chunhong Xie, Yiying Zhang, Yujia Wang, Fangqi Gong
Format: Article
Language:English
Published: Nature Portfolio 2025-02-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-91042-8
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author Lichao Gao
Zhufei Xu
Jian Hu
Qing Zhang
Songling Fu
Wei Wang
Chunhong Xie
Yiying Zhang
Yujia Wang
Fangqi Gong
author_facet Lichao Gao
Zhufei Xu
Jian Hu
Qing Zhang
Songling Fu
Wei Wang
Chunhong Xie
Yiying Zhang
Yujia Wang
Fangqi Gong
author_sort Lichao Gao
collection DOAJ
description Abstract Patients infected with SARS-CoV-2 may experience acute and long-term immune disorders. Immunological factors are thought to play an important role in Kawasaki disease. To analyze the impact of COVID-19 infection on Kawasaki disease, this study retrospectively analyzed 161 children with Kawasaki disease onset during the COVID-19 pandemic. The proportion of IVIG-Resistant individuals and the rate of corticosteroid use in the 1–7 weeks from COVID-19 infection to Kawasaki disease onset were higher than that of the noninfected group, even after excluding suspected cases of multiple system inflammatory syndrome. Compared to the noninfected group, the level of CD4 was lower, and the levels of CD3−CD16+CD56+, complement C4, TNF-α, and IFN-γ were higher in the 1–7 weeks after COVID-19 infection. In conclusion, the risk of IVIG resistance was significantly increased in children with Kawasaki disease onset 1–7 weeks after COVID-19 infection, which may be related to the long-term impact of COVID-19 on immunity.
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spelling doaj-art-e12f754e9c1a4962bad3437cbe29d91a2025-08-20T03:13:12ZengNature PortfolioScientific Reports2045-23222025-02-0115111010.1038/s41598-025-91042-8Impact of COVID-19 infection on Kawasaki disease and immune status in childrenLichao Gao0Zhufei Xu1Jian Hu2Qing Zhang3Songling Fu4Wei Wang5Chunhong Xie6Yiying Zhang7Yujia Wang8Fangqi Gong9Department of Cardiology, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child HealthDepartment of Pulmonology, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child HealthDepartment of Cardiology, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child HealthDepartment of Cardiology, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child HealthDepartment of Cardiology, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child HealthDepartment of Cardiology, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child HealthDepartment of Cardiology, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child HealthDepartment of Cardiology, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child HealthDepartment of Cardiology, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child HealthDepartment of Cardiology, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child HealthAbstract Patients infected with SARS-CoV-2 may experience acute and long-term immune disorders. Immunological factors are thought to play an important role in Kawasaki disease. To analyze the impact of COVID-19 infection on Kawasaki disease, this study retrospectively analyzed 161 children with Kawasaki disease onset during the COVID-19 pandemic. The proportion of IVIG-Resistant individuals and the rate of corticosteroid use in the 1–7 weeks from COVID-19 infection to Kawasaki disease onset were higher than that of the noninfected group, even after excluding suspected cases of multiple system inflammatory syndrome. Compared to the noninfected group, the level of CD4 was lower, and the levels of CD3−CD16+CD56+, complement C4, TNF-α, and IFN-γ were higher in the 1–7 weeks after COVID-19 infection. In conclusion, the risk of IVIG resistance was significantly increased in children with Kawasaki disease onset 1–7 weeks after COVID-19 infection, which may be related to the long-term impact of COVID-19 on immunity.https://doi.org/10.1038/s41598-025-91042-8Kawasaki diseaseCOVID-19ImmunityIVIG resistanceChild
spellingShingle Lichao Gao
Zhufei Xu
Jian Hu
Qing Zhang
Songling Fu
Wei Wang
Chunhong Xie
Yiying Zhang
Yujia Wang
Fangqi Gong
Impact of COVID-19 infection on Kawasaki disease and immune status in children
Scientific Reports
Kawasaki disease
COVID-19
Immunity
IVIG resistance
Child
title Impact of COVID-19 infection on Kawasaki disease and immune status in children
title_full Impact of COVID-19 infection on Kawasaki disease and immune status in children
title_fullStr Impact of COVID-19 infection on Kawasaki disease and immune status in children
title_full_unstemmed Impact of COVID-19 infection on Kawasaki disease and immune status in children
title_short Impact of COVID-19 infection on Kawasaki disease and immune status in children
title_sort impact of covid 19 infection on kawasaki disease and immune status in children
topic Kawasaki disease
COVID-19
Immunity
IVIG resistance
Child
url https://doi.org/10.1038/s41598-025-91042-8
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