Obesity and Outcomes of Kawasaki Disease and COVID-19–Related Multisystem Inflammatory Syndrome in Children
Authors' conclusion
In this international cohort study, obesity was more prevalent for patients with MIS-C vs KD, and associated with more severe presentation, laboratory test features, and outcomes.
Study context
- Population
- Contemporaneous children with Kawasaki disease (KD) or multisystem inflammatory syndrome in children (MIS-C) in the International Kawasaki Disease Registry, January 1, 2020, to July 31, 2022 (42 sites, 8 countries)
- Participants
- 1,767 children42 sites8 countries
- Exposure
- MIS-C vs KD; adiposity categories within each disease
- MIS-Cn = 1,429
- KDn = 338reference
- Outcome
- Prevalence of obesity (body mass index (BMI) ≥95th percentile) and overweight (BMI ≥85th to <95th percentile) and associations of adiposity category with clinical outcomes
Methodological detailsinternational registry (International Kawasaki Disease Registry (IKDR)), multicentre (42 sites, 8 countries)
- International registry (IKDR)
- Multicentre (42 sites, 8 countries)
Main finding
As reported in the abstract
Prevalence of overweight and obesity
Overweight
Obesity
- MIS-C vs KD: P < 0.001 — significantly higher overweight and obesity prevalence in MIS-C; higher adiposity z scores even after adjustment for age, sex, and race and ethnicity
Observational data: associations, not effects.
Further findings
Adiposity category and outcomes in KD
- Apart from ICU admission rate, adiposity category not associated with laboratory test features or outcomes
Adiposity category and outcomes in MIS-C
- Higher adiposity category associated with greater likelihood of shock, ICU admission and inotrope requirement, and increased inflammatory markers, creatinine and alanine aminotransferase levels
Coronary artery abnormalities
- Adiposity category not associated with coronary artery abnormalities for either MIS-C or KD
Original publication
Obesity and Outcomes of Kawasaki Disease and COVID-19–Related Multisystem Inflammatory Syndrome in Children. JAMA Netw Open. Published 1 December 2023. doi:10.
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