Prolonged fever predicts coronary artery aneurysms in children with KD

In children with Kawasaki Disease (KD), fever >7 days is significantly associated with coronary artery abnormalities (CAAs), a study has found. Early diagnosis may help prevent morbidity.

A group of researchers conducted this retrospective study involving a cohort of 50 patients with KD (median age 2.6 years) in North India over 5 years. They obtained data from the medical records of patients from 2020 and 2024.

Fever was universal, with a median duration of 7.5 days. The most common clinical features were oral mucosal changes (68 percent) and rash (64 percent). Thirty-three children were diagnosed with CAAs (66 percent), comprising coronary dilatation (12.1 percent), small aneurysms (54.6 percent), medium aneurysms (24.2 percent), and giant aneurysms (9.1 percent).

Left-sided coronary involvement (ie, left main and left anterior descending arteries) was the leading abnormality and was associated with persistence of aneurysms on follow-up. Younger age and prolonged fever significantly correlated with CAAs (p<0.05), but other classical clinical features did not.

Intravenous immunoglobulin and aspirin were administered to all patients. Of the patients, 72 percent had available follow-up echocardiography, 69.7 percent had complete resolution of CAAs, and 30.3 percent had persistent but regressing aneurysms. None of the children died or experienced long-term adverse effects on follow-up.