Association of Kawasaki disease with intellectual disability, attention deficit hyperactivity disorder, and autism spectrum disorder: a systematic review and meta-analysis

Background: The relationship between Kawasaki disease (KD) and neurodevelopmental disorders (NDDs) remains unclear. This study aims to explore the association between them. Method: A systematic review was conducted using PubMed and Embase databases from inception to May 1, 2024 (INPLASY202450017). We included case-control or cohort studies comparing KD patients to healthy controls in assessing attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and intellectual disability (ID). The meta-analysis employed a random-effects model to calculate effect sizes using hazard ratios (HRs) with 95% confidence intervals (CIs) for the disease occurrence. Moreover, mean differences (MDs) were used to calculate intelligence quotient (IQ). Results: Four eligible studies, including 1,454,499 participants, were analyzed for ADHD, ASD, and ID. Additionally, three studies with 365 participants were analyzed for IQ. The risk of ADHD in KD patients was higher than in healthy controls (HR[95%CI]=1.76[1.21–2.57]). However, the risks of ASD (HR[95%CI]=1.68[0.47–5.94]) and ID (HR[95%CI]=1.39[0.52–2.63]) were not significantly different between KD and controls. IQ comparisons showed no significant differences in full IQ (MD[95%CI]=-0.01[-2.44–2.42]), verbal IQ (MD[95%CI]=-1.05[-4.42–2.33]), and performance IQ (MD[95%CI]=-0.08[-2.75–2.59]). Conclusion: This study indicates that individuals with KD have a higher risk for ADHD but not for ASD or ID. Trial registration: INPLASY202450017