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Kawasaki Disease and Clinical Outcome Disparities Among Black Children.
Padilla, Luz A; Collins, Jacqueline L; Idigo, Adeniyi J; Lau, Yung; Portman, Michael A; Shrestha, Sadeep.
  • Padilla LA; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL. Electronic address: lpadilla@uabmc.edu.
  • Collins JL; Department of Pediatric Cardiology, School of Medicine, University of Alabama at Birmingham and the Pediatric and Congenital Heart Center of Alabama, Children's of Alabama, Birmingham, AL.
  • Idigo AJ; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL.
  • Lau Y; Department of Pediatric Cardiology, School of Medicine, University of Alabama at Birmingham and the Pediatric and Congenital Heart Center of Alabama, Children's of Alabama, Birmingham, AL.
  • Portman MA; Division of Pediatric Cardiology, Department of Pediatrics, University of Washington and Seattle Children's Research Institute, Seattle, WA.
  • Shrestha S; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL.
J Pediatr ; 229: 54-60.e2, 2021 02.
Article in English | MEDLINE | ID: covidwho-793095
ABSTRACT

OBJECTIVE:

To determine whether Black children with Kawasaki disease exhibit disparities in prevalence, sequelae, and response to intravenous gamma globulin (IVIG) treatment. STUDY

DESIGN:

International Classification of Diseases codes were used to identify children with Kawasaki disease admitted to a tertiary center in the southeastern US. Subjects diagnosed and treated according to American Heart Association criteria were included. Demographic, laboratory, clinical, and echocardiographic data from the electronic medical record (2000-2015) were compared between Blacks and Whites.

RESULTS:

Data from 369 subjects (52% Whites and 48% Blacks) were included in our analysis. No significant differences related to timely admission, IVIG treatment, or coronary artery (CA) abnormalities during hospitalization were observed. Blacks showed lower IVIG response rates than Whites for patients administered IVIG within 10 days of fever onset (86.6% vs 95.6%; P = .007). Blacks received more ancillary drugs (9.6% vs 2.6%; P = .003), and endured longer hospitalizations (mean, 5 ± 3.9 days vs 3.4 ± 2.2 days; P = .001). Blacks presented with higher C-reactive protein level and erythrocyte sedimentation rate and lower hemoglobin, albumin, and sodium levels. Blacks had a higher proportion of persistent CA abnormalities than Whites at second follow-up echocardiogram (14.5% vs 6.3%; P = .03), and at third follow-up echocardiogram (21.2% vs 6.9%; P = .01).

CONCLUSIONS:

Compared with White children, Black children with Kawasaki disease had higher IVIG refractory prevalence, more severe inflammation, more ancillary treatments, and longer hospitalizations. Despite no racial differences in time to diagnosis or initial treatment, there was greater CA abnormality persistence among Black children at follow-up.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Black or African American / Health Status Disparities / Mucocutaneous Lymph Node Syndrome Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Child, preschool / Female / Humans / Male Country/Region as subject: North America Language: English Journal: J Pediatr Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Black or African American / Health Status Disparities / Mucocutaneous Lymph Node Syndrome Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Child, preschool / Female / Humans / Male Country/Region as subject: North America Language: English Journal: J Pediatr Year: 2021 Document Type: Article