ABSTRACT
Introduction: Renal disorders are reported as both underlying conditions (such as hydronephrosis, chronic kidney disease, kidney anomalies) and complications (acute kidney injury, hematuria, proteinuria, hypertension) of COVID-19 infection, particularly in critically ill pediatric patients. Early diagnosis of kidney involvement and application of appropriate treatment can help prevent long-term complications and may be a determining factor in reducing the mortality rate. In this viewpoint, we aimed to investigate the pattern of renal involvement, particularly acute kidney injury (AKI), among pediatric patients with COVID-19. Method(s): From March 1 to December 30, 2020, we prospectively enrolled 187 pediatric patients admitted to Mofid Children's Hospital with the clinical diagnosis of COVID-19 infection. Demographic, clinical, and laboratory findings were gathered and analyzed using a mixed method of qualitative and quantitative approaches and descriptive statistics. Result(s): One hundred eighty-seven patients, including 120 (64.2%) male and 67 (35.8%) females with COVID-19 infection at a median (interquartile range) of 60 (24 - 114) months, were enrolled in this study. Most patients (n = 108, 58.1%) were suffered from one or two underlying comorbidities, mainly malnutrition (77.4%), neurologic/ learning disorders (21.4%), and malignancy (10.2%). The kidney was the third organ involved in 30 patients (16%) during hospital admission, after lung (53.5%) and gastrointestinal tract (39%). According to the KDIGO classification, AKI was detected in 38.5% of patients (stage 1: 55.6%, stage 2: 36.1%, stage 3: 8.3%) at presentation or follow-up. Nine patients (4.8%) required hemodialysis, and 16 (8.6%) patients were eventually died. There was no significant association between AKI and pediatric intensive care unit (PICU) admission (P = 0.079), a multisystem inflammatory syndrome in children (MIS-C) (P = 0.051), comorbidities (P = 0.067), and mortality rate (P = 0.789). Conclusion(s): Along with the lungs and gastrointestinal tract, the kidneys are major organs affected by COVID-19. Although kidney abnormalities resolve in most pediatric COVID-19 infections, particular attention should be given to kidney involvement in COVID-19 patients, particularly children with a history of malnutrition and renal disorders.
ABSTRACT
Background: To date, coronavirus disease-2019 (COVID-19) has infected over 82 million people globally. The first confirmed case in the United Arab Emirates (UAE)was reported on 29th January 2020. Current data suggests that children with COVID-19 have a mild disease course. There is a lack of extensive published data about COVID-19 infection among children in the Arabian Gulf region.