{"doi":"10.1016/j.cjcpc.2025.07.001","title":"Effect of the COVID-19 Pandemic on the Epidemiology of Kawasaki Disease in Canada","abstract":"Background COVID-19 substantially changed the epidemiology of Kawasaki disease (KD), with decreased incidence reported globally. We sought to determine its effect in Canada. Methods Pediatric admissions for KD (2004-2023) were identified through the Canadian Institute for Health Information. Clinical data for KD hospitalizations at The Hospital for Sick Children in Toronto (2016-June 2023) were manually reviewed. Results KD incidence was stable prior to the pandemic (22.5/100,000 0-4 year-old/year,p=0.19). There was a 30% reduction early pandemic (2020-2021) across all regions (15.8 cases/100,000 0-4 year-old) with blunting of traditional winter peaks. In the summer of 2022, an atypical peak in KD incidence was observed, aligning with the Delta wave. Epidemiology returned to normal patterns in 2023-2024 (+7% vs. pre-pandemic to 24.1 cases/100,000 0-4 year-old), with notable differences in Ontario and the Prairies. Patients diagnosed in the early pandemic were more likely to present with incomplete KD (odds ratio (95% confidence interval) OR:4.84(3.22-7.30),p=0.008), respiratory (OR:2.59(1.70-7.30),p=0.03) or abdominal symptoms (OR:4.84(3.15-7.44),p<.001). Those diagnosed in the late pandemic also presented with more incomplete KD (OR:1.76(1.16-2.66),p<0.001), respiratory (OR:1.70(1.05-2.75),p<0.001) or abdominal symptoms (OR:2.53(1.73-3.70),p<.001), albeit to a lesser extent, along with a shorter duration of fever before diagnosis (EST:-0.82(-1.52;-0.12) days, p=0.02) and higher odds of developing KD shock syndrome (OR:4.66(1.83-11.87),p=0.001). Throughout the pandemic, odds of developing giant coronary aneurysms or admission to the intensive care unit remained similar. Conclusions The pandemic saw the incidence of KD decrease significantly with disrupted seasonality. Pre-pandemic epidemiological patterns have returned. Patient presentations changed but outcomes remained stable compared to the pre-pandemic period.","journal":"CJC Pediatric and Congenital Heart Disease","year":2025,"id":553639,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.7415,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1450599,"name":"Dominic Gangemi","orcid":null,"position":1,"is_corresponding":false},{"id":1060611,"name":"Pedrom Farid","orcid":"0000-0002-3927-5461","position":2,"is_corresponding":false},{"id":1450600,"name":"Sunita O’Shea","orcid":null,"position":3,"is_corresponding":false},{"id":1450601,"name":"Tanveer Collins","orcid":null,"position":4,"is_corresponding":false},{"id":1450602,"name":"Nita Chahal","orcid":null,"position":5,"is_corresponding":false},{"id":1450603,"name":"Rayan Rahman","orcid":null,"position":6,"is_corresponding":false},{"id":1450604,"name":"Vitor Guerra","orcid":null,"position":7,"is_corresponding":false},{"id":55575,"name":"Brian W. McCrindle","orcid":"0000-0001-6485-6551","position":8,"is_corresponding":false},{"id":952019,"name":"Cedric Manlhiot","orcid":"0000-0001-9419-7681","position":9,"is_corresponding":false},{"id":1450211,"name":"Nina Butris","orcid":"0000-0003-2576-1909","position":0,"is_corresponding":true}],"reference_count":18,"raw_metadata":null,"created_at":"2026-07-19T02:54:41.819682Z","pmid":"41607721","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}