Predictive value of serum lipid for kawasaki disease shock syndrome: a prospective study

Background Kawasaki disease shock syndrome (KDSS) is a severe form of Kawasaki disease (KD). The serum lipid has been proposed to be valuable in predicting shock syndrome in clinical circumstances; however, limited data is available in KDSS patients. Therefore, we prospectively evaluated the ability of serum lipid in predicting KDSS. Methods A total of 1009 KD patients aged 2 months to 139 months were enrolled in this prospective cohort study between June 2017 and April 2022. The demographic/clinical characteristics and laboratory data were compared between the patients with KDSS (KDSS group) and those without (KD group). Multivariate logistic regression analysis was utilized to determine the correlation between serum lipid and KDSS. Receiver operating characteristic (ROC) curve analysis was subsequently performed to assess the validity of serum lipids in predicting KDSS. Results Except for triglyceride (TG), almost all the levels of detected lipid profiles were significantly lower in the KDSS subjects compared to non-KDSS patients. In terms of KDSS prediction, the cut-off values of 2.845 mmol/L, 0.355 mmol/L, 1.405 mmol/L, 0.595 g/L, and 0.805 g/L for total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A (Apo A) and apolipoprotein B (Apo B), yielded sensitivities of 80%, 68%, 64%, 76% and 88%, with specificities of 69%, 93%, 89%, 83% and 51%, respectively. Conclusions Lipid profiles were robustly dysregulated in KDSS patients. Noticeably, serum lipid was a complementary laboratory marker for KDSS prediction.