Kawasaki Disease and Neurological Sequelae: Unveiling Long-Term Risks in Children

Background and Objectives: Kawasaki Disease (KD) is a childhood vasculitis with potential long-term neurological implications. This study examines the association between KD and subsequent neuropsychiatric and neurodevelopmental disorders using national health data from South Korea. Materials and Methods: Using the National Health Infor-mation Database, we identified KD patients diagnosed between 2002 and 2021 and se-lected those born between 2008 and 2015. A 1:4 propensity score matching was applied to create a control group. The incidence of neuropsychiatric and neurodevelopmental disor-ders from 2017 to 2021 was analyzed using Cox proportional hazards models, adjusting for age, sex, and urbanicity. Results: The study included 41,806 KD subjects and 163,829 matched controls. KD was associated with an increased risk of certain neuropsychiatric disorders: anxiety disorder (HR 1.124, 1.047–1.207), sleep-related disorder (HR 1.257, 1.094–1.444), movement disorder (HR 1.227, 1.030–1.461), and any neuropsychiatric dis-order (HR 1.102, 1.053–1.153). For neurodevelopmental disorders, KD patients showed a lower incidence of intellectual disability (HR 0.747, 0.641–0.871) but an increased risk of tic disorder (HR 1.148, 1.020–1.292). No significant associations were found with other neurodevelopmental disorders. Male gender and urban residency were associated with higher incidence rates for certain conditions. Conclusions: KD patients show increased risks for anxiety, sleep-related, movement disorder and tic disorder, a reduced incidence of intellectual disability, and a higher risk of tic disorder. These findings highlight the need for long-term neurological monitoring in KD patients and provide insights into its poten-tial neurodevelopmental impact.