Impaired cardiopulmonary functions in prepubertal patients with Kawasaki disease

• Prepubertal children with Kawasaki disease have lower aerobic capacity and exercise tolerance. • Males with Kawasaki disease are more severely affected in cardiopulmonary function than females. • Despite reduced capacity, KD children can safely engage in vigorous physical activities. • Regular exercise is crucial for improving long-term cardiopulmonary health in KD patients. This study investigated the cardiopulmonary function of prepubertal patients with Kawasaki Disease (KD) and compared it with that of healthy controls. Retrospective cohort study Data were collected from two medical centers in Taiwan from January 2014 to December 2023. Patients aged 8 to 12 years with a KD history were recruited. All patients and controls (age-, sex-, and body mass index -matched) underwent Cardiopulmonary Exercise Test (CPET) and pulmonary function test. A total of 117 KD patients (mean age 9.64 ± 1.66 years; 68 males (58.1 %); (Body Mass Index [BMI] 19.21 ± 4.20 kg/m 2 ) and 121 controls (mean age 9.72 ± 1.66 years; 71 males (58.7 %); BMI 18.47 ± 3.30 kg/m 2 ) were analyzed. The average time from illness onset to enrollment was 7.94 ± 2.84 years. No significant differences in demographic characteristics or pulmonary function were observed. However, the KD group exhibited lower aerobic capacity (24.32 ± 5.02 vs. 26.08 ± 4.89 mL/min/kg, p < 0.001) and peak exercise tolerance (35.43 ± 7.31 vs. 38.48 ± 6.24 mL/min/kg, p < 0.001) compared to controls. Furthermore, the KD group had lower cardiopulmonary function than the control group among males, whereas the difference in females did not reach statistical significance. Prepubertal individuals with a KD history demonstrated lower aerobic capacity and peak exercise tolerance than healthy peers, particularly among males. Despite this, they can safely engage in moderate-to-vigorous physical activities, which are essential for maintaining cardiopulmonary health in later life. Encouraging regular exercise among these patients is crucial.