ABSTRACT
Background: The impact of COVID-19 disease on previously healthy children has been minimal, yet there is limited data on the impact of COVID-19 on children and adolescents with kidney transplants. Methods: We used the existing infrastructure of the Improving Renal Outcomes Collaborative (IROC) learning health system to develop and rapidly implement a webbased registry for collecting clinical and outcomes data about COVID-19 disease in pediatric transplant recipients. We distributed the registry to 32 U.S. pediatric kidney transplant centers and requested clinical and outcomes data from all recipients suspected of having COVID-19 disease. Here, we present an interim analysis of the first 6 weeks of registry data. Results: Between April 6 and May 27, 2020, 18 IROC centers entered data on 99 pediatric kidney transplant recipients who had PCR based testing for COVID-19. 54 patients were tested due to symptoms of COVID-19 (most commonly fever and cough), 7 asymptomatic patients had a known COVID exposure. 34 patients were tested per hospital policy (e.g. pre-anesthesia), and 4 did not have a reported testing indication. Overall, 10/99 (10%) tested positive for COVID-19, 6 of whom had any symptoms, 3 had a known exposure with a COVID+ individual, and 1 was diagosed by a pre-anesthesia screen. Thus far, the clinical course and outcomes are known in 8/10 COVID-19+ patients: 5 received outpatient supportive care alone, 2 were admitted to intensive care and 1 was admitted to a non-intensive care inpatient unit. Transplant outcomes were excellent in all COVID-19+ patients. There were no cases with respiratory failure, acute kidney injury, or allograft rejection/failure. There were no deaths due to COVID-19 disease. Conclusions: In this interim analysis of the IROC learning health system, pediatric kidney transplant recipients had a relatively low incidence of COVID-19 disease and excellent short-term outcomes.