PMID- 37170763
OWN - NLM
STAT- MEDLINE
DCOM- 20231128
LR  - 20231128
IS  - 2154-1671 (Electronic)
IS  - 2154-1671 (Linking)
VI  - 13
IP  - 6
DP  - 2023 Jun 1
TI  - Viral Coinfections in Kawasaki Disease: A Meta-analysis.
PG  - e153-e169
LID - 10.1542/hpeds.2023-007150 [doi]
AB  - CONTEXT: Viral infections are suspected triggers in Kawasaki disease (KD); 
      however, a specific viral trigger has not been identified. OBJECTIVES: In 
      children with KD, to identify (1) overall prevalence of viral infections; (2) 
      prevalence of specific viruses; and (3) whether viral positivity was associated 
      with coronary artery aneurysms (CAAs) or refractoriness to intravenous 
      immunoglobin (IVIG). DATA SOURCES: We searched Embase, Medline, and Cochrane 
      databases and gray literature. STUDY SELECTION: Eligible studies were conducted 
      between 1999 and 2019, and included children diagnosed with KD who underwent 
      viral testing. DATA EXTRACTION: Two investigators independently reviewed 
      full-text articles to confirm eligibility, extract data, appraise for bias, and 
      assess evidence quality for outcomes using the Grading of Recommendations 
      Assessment Development and Evaluation criteria. We defined viral positivity as 
      number of children with a positive viral test divided by total tested. Secondary 
      outcomes were CAA (z score >/=2.5) and IVIG refractoriness (fever >/=36 hours after 
      IVIG). RESULTS: Of 3189 unique articles identified, 54 full-text articles were 
      reviewed, and 18 observational studies were included. Viral positivity weighted 
      mean prevalence was 30% (95% confidence interval [CI], 14-51) and varied from 5% 
      to 66%, with significant between-study heterogeneity. Individual virus positivity 
      was highest for rhinovirus (19%), adenovirus (10%), and coronavirus (7%). Odds of 
      CAA (odds ratio, 1.08; 95% CI, 0.75-1.56) or IVIG refractoriness (odds ratio, 
      0.88; 95% CI, 0.58-1.35) did not differ on the basis of viral status. 
      LIMITATIONS: Low or very low evidence quality. CONCLUSIONS: Viral infection was 
      common with KD but without a predominant virus. Viral positivity was not 
      associated with CAAs or IVIG refractoriness.
CI  - Copyright (c) 2023 by the American Academy of Pediatrics.
FAU - Neubauer, Hannah C
AU  - Neubauer HC
AD  - Department of Pediatrics, Children's Hospital Colorado and University of Colorado 
      School of Medicine, Aurora, Colorado.
FAU - Lopez, Michelle A
AU  - Lopez MA
AD  - Divisions of Pediatric Hospital Medicine.
AD  - Texas Children's Hospital, Houston, Texas.
FAU - Haq, Heather A
AU  - Haq HA
AD  - Divisions of Pediatric Hospital Medicine.
AD  - Texas Children's Hospital, Houston, Texas.
FAU - Ouellette, Lara
AU  - Ouellette L
AD  - Texas Medical Center Library, Houston, Texas.
FAU - Ramirez, Andrea A
AU  - Ramirez AA
AD  - Rheumatology, Department of Pediatrics, Baylor College of Medicine, Houston, 
      Texas.
AD  - Texas Children's Hospital, Houston, Texas.
FAU - Wallace, Sowdhamini S
AU  - Wallace SS
AD  - Divisions of Pediatric Hospital Medicine.
AD  - Texas Children's Hospital, Houston, Texas.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PL  - United States
TA  - Hosp Pediatr
JT  - Hospital pediatrics
JID - 101585349
RN  - 0 (Immunoglobulins, Intravenous)
SB  - IM
MH  - Child
MH  - Humans
MH  - Infant
MH  - *Mucocutaneous Lymph Node Syndrome/epidemiology/complications
MH  - Immunoglobulins, Intravenous/therapeutic use
MH  - *Coinfection/complications
MH  - Fever/complications
MH  - *Virus Diseases/complications
EDAT- 2023/05/12 07:06
MHDA- 2023/11/28 06:42
CRDT- 2023/05/12 04:13
PHST- 2023/11/28 06:42 [medline]
PHST- 2023/05/12 07:06 [pubmed]
PHST- 2023/05/12 04:13 [entrez]
AID - 191258 [pii]
AID - 10.1542/hpeds.2023-007150 [doi]
PST - ppublish
SO  - Hosp Pediatr. 2023 Jun 1;13(6):e153-e169. doi: 10.1542/hpeds.2023-007150.