Heat-related increase in Kawasaki disease risk with delayed effects: Evidence from time-series and case-crossover analyses in Seoul, South Korea

IF 3.2 2区生物学 Q2 BIOLOGY

Journal of thermal biology Pub Date : 2026-07-01 Epub Date: 2026-06-11 DOI:10.1016/j.jtherbio.2026.104508

Kiook Baek, Jung Hee Hong

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引用次数: 0

Abstract

Background

This study examined the association between ambient temperature and Kawasaki disease (KD) incidence, emphasizing delayed effects and age-specific susceptibility using nationwide data from Seoul, Korea.

Methods

KD cases treated with intravenous immunoglobulin among children aged 0–9 years in Seoul (2012–2019) were identified from the HIRA database and coded daily. Associations between mean temperature and KD were analyzed using a time-stratified case-crossover design and quasi-Poisson time-series regression within a distributed lag non-linear model (up to 21 lag days).

Results

In the case-crossover analysis, KD risk increased linearly above 25 °C at a cumulative lag of 14–21 days, with an odds ratio (OR) of 1.13 (95% CI: 1.03–1.23) at 29.7 °C (97.5th percentile) versus 25 °C. The time-series model showed similar results, with a relative risk (RR) of 1.14 (95% CI: 1.05–1.25) at 29.7 °C. No significant decrease was observed at low temperatures (−6.9 °C). Age-stratified analyses revealed the strongest associations among children aged 1–4 years.

Conclusions

High ambient temperature was associated with a delayed increase in KD incidence, particularly among children aged 1–4 years. These findings suggest that heat exposure may play a role in KD pathogenesis, potentially through effects on infection susceptibility and host immune responses.

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具有延迟效应的高温相关川崎病风险增加：来自韩国首尔的时间序列和病例交叉分析的证据

背景：本研究调查了环境温度与川崎病（KD）发病率之间的关系，使用韩国首尔的全国数据，强调延迟效应和年龄特异性易感性。方法：从HIRA数据库中确定首尔地区（2012-2019）0-9岁儿童中静脉注射免疫球蛋白治疗的KD病例，并每天进行编码。使用时间分层病例交叉设计和准泊松时间序列回归分析了平均温度和KD之间的关系，并采用分布滞后非线性模型（最长21滞后天）。结果：在病例交叉分析中，KD风险在25 °C以上呈线性增加，累积滞后14-21天，在29.7 °C（97.5%）与25 °C时的比值比（OR）为1.13 （95% CI: 1.03-1.23）。时间序列模型显示了类似的结果，在29.7 °C时，相对风险（RR）为1.14 （95% CI: 1.05-1.25）。在低温（-6.9 °C）下没有观察到明显的减少。年龄分层分析显示，1-4岁儿童的相关性最强。结论：高环境温度与KD发病率的延迟增加有关，特别是在1-4岁的儿童中。这些发现表明，热暴露可能在KD发病机制中发挥作用，可能通过影响感染易感性和宿主免疫反应。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of thermal biology 生物-动物学

CiteScore

5.30

自引率

7.40%

发文量

196

审稿时长

14.5 weeks

期刊介绍： The Journal of Thermal Biology publishes articles that advance our knowledge on the ways and mechanisms through which temperature affects man and animals. This includes studies of their responses to these effects and on the ecological consequences. Directly relevant to this theme are: • The mechanisms of thermal limitation, heat and cold injury, and the resistance of organisms to extremes of temperature • The mechanisms involved in acclimation, acclimatization and evolutionary adaptation to temperature • Mechanisms underlying the patterns of hibernation, torpor, dormancy, aestivation and diapause • Effects of temperature on reproduction and development, growth, ageing and life-span • Studies on modelling heat transfer between organisms and their environment • The contributions of temperature to effects of climate change on animal species and man • Studies of conservation biology and physiology related to temperature • Behavioural and physiological regulation of body temperature including its pathophysiology and fever • Medical applications of hypo- and hyperthermia Article types: • Original articles • Review articles