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INTRODUCTION. The aetiology of Kawasaki disease (KD) remains unknown. Changes in infectious exposure during the COVID-19 pandemic owing to infection prevention measures may have affected the incidence of KD, supporting the pathogenic role of an infectious trigger. The purpose of this study was to evaluate the incidence, phenotype and outcome of KD before and during the COVID-19 pandemic in Denmark. METHODS. This was a retrospective cohort study based on patients diagnosed with KD at a Danish paediatric tertiary referral centre from 1 January 2008 to 1 September 2021. RESULTS. A total of 74 patients met the KD criteria of whom ten were observed during the COVID-19 pandemic in Denmark. Alof these patients were negative for SARS-CoV-2 DNA and antibodies. A high KD incidence was observed during the first six months of the pandemic, but no patients were diagnosed during the following 12 months. Clinical KD criteria were equally met in both groups. The fraction of intravenous immunoglobulin (IVIG) non-responders was higher in the pandemic group (60%) than in the in the pre-pandemic group (28.3%), although the rate of timely administered IVIG treatment was the same in both groups (>= 80%). Coronary artery dilation was observed in 21.9% in the pre-pandemic group compared with 0% in KD patients diagnosed during the pandemic. CONCLUSION. Changes in KD incidence and phenotype were seen during the COVID-19 pandemic. Patients diagnosed with KD during the pandemic had complete KD, higher liver transaminases and significant IVIG resistance but no coronary artery involvement.Copyright © 2023, Almindelige Danske Laegeforening. All rights reserved.
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Background The COVID-19 pandemic may have increased the need for help and support for adolescents with disabilities. At the same time, moving to distance learning can reduce access to support services. Despite this, little is known about this issue. Thus, we investigated differences in the unmet need for help and support between adolescents with and without disabilities during the COVID-19 pandemic. Methods We analyzed large population-based data from the Finnish School Health Promotion study obtained during 2019 and 2021 (2019: n = 87,215;2021: n = 91,560). The target group comprised adolescents from lower secondary schools in Finland (age: M = 15.3, SD = .64). Logistic regression models were applied to investigate differences in the unmet need for help and support between adolescents with and without disabilities. Results During the pandemic, adolescents with disabilities reported insufficient help and support related to their learning and well-being from teachers, school curators and psychologists, and school nurses and doctors more often than other adolescents (p < .001). Adolescents with disabilities reported more often than others that distance learning involved insufficient learning support (p < .001). Between 2019 and 2021, an increasing proportion of adolescents with disabilities felt that they had received insufficient help and support related to their well-being from nurses, doctors, psychologists, school curators, and teachers. To summarize, the COVID-19 pandemic reduced access to support and assistance for adolescents, particularly those with disabilities. Conclusions Policies in schools should be developed and resources secured so that support and help for adolescents with disabilities can be secured in exceptional circumstances. Insufficient support and assistance for adolescents with disabilities can impair their learning outcomes and health. Key messages • During the COVID-19 pandemic, adolescents with disabilities reported insufficient help and support related to their learning and well-being more often than other adolescents. • In times of crisis, support and help for adolescents with disabilities must be guaranteed.